Excelsior Omega Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EXCELSIOR OMEGA INC.

Practice address

3548 Sea View St
Sarasota, FL 34239-3417

Phone

(941) 807-9657

Fax

(941) 282-7673

NPI assigned

Sep 3, 2025

Last updated

Oct 23, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

EXCELSIOR OMEGA INC.As reported in NPPES

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

Authorized official

Name

Jacqueline Dorelien

Title

Manager

Phone

(941) 807-9657

Specialties & licenses 1

Addresses

Part of

Excelsior Omega Inc

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

{
    "created_epoch": "1756857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761177600000",
    "number": "1801776661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 DADE AVE",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342321608",
            "telephone_number": "941-371-4091",
            "fax_number": "941-282-7673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3548 SEA VIEW ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342393417",
            "telephone_number": "941-807-9657",
            "fax_number": "941-282-7673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2731 23rd St",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342347857",
            "country_code": "US",
            "telephone_number": "941-807-9657",
            "fax_number": "941-282-7673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EXCELSIOR OMEGA INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXCELSIOR OMEGA INC.",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A",
        "authorized_official_last_name": "DORELIEN",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "941-807-9657"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; 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.