NPIMap

Organization Active NPI

Gomes Place LLC

  • Assisted Living Facility
  • Lutz, FL
National Provider Identifier
1780070078
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL 12621 Issued in FL
Legal business name
GOMES PLACE LLC
Practice address
17607 Simmons Rd
Lutz, FL 33548-4596
Phone
(813) 506-1432
Fax
(813) 909-7390
NPI assigned
Apr 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Eddy T OgbekhiluNPI 1366833105
Title
Administrator
Phone
(813) 506-1432

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL 12621 FL Primary

Addresses

Primary practice location

17607 Simmons Rd
Lutz, FL 33548-4596

Mailing address

17607 Simmons Rd
Lutz, FL 33548-4596
Phone (813) 506-1432

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428883200000",
    "number": "1780070078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17607 SIMMONS RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335484596",
            "telephone_number": "813-506-1432",
            "fax_number": "813-909-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17607 SIMMONS RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335484596",
            "telephone_number": "813-506-1432",
            "fax_number": "813-909-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOMES PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-13",
        "last_updated": "2015-04-13",
        "status": "A",
        "authorized_official_last_name": "OGBEKHILU",
        "authorized_official_first_name": "EDDY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "813-506-1432",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL 12621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.