Pembrook Place 2, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL7581 Issued in FL

Legal business name

PEMBROOK PLACE 2, INC.

Doing business as

Pembrook Place II Assisted Living Facility

Practice address

1623 Robinhood LN
Clearwater, FL 33764-6447

Phone

(727) 539-6872

Fax

(727) 213-9068

NPI assigned

Mar 7, 2014

Organization subpart

No

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

Authorized official

Name

Michael Monteclaro

Title

President/Administrator

Phone

(727) 656-2245

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pembrook Place II Assisted Living Facility Doing business as

Tax ID family

Pembrook Place 2 Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pembrook Place 2 Inc

  • Assisted Living Facility
  • Clearwater, FL
  • NPI 1841544319
  NPD tax ID

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

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394150400000",
    "number": "1831515345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7619",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337587619",
            "telephone_number": "727-656-2245",
            "fax_number": "727-213-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 ROBINHOOD LN",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337646447",
            "telephone_number": "727-539-6872",
            "fax_number": "727-213-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEMBROOK PLACE 2, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-07",
        "last_updated": "2014-03-07",
        "status": "A",
        "authorized_official_last_name": "MONTECLARO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/ADMINISTRATOR",
        "authorized_official_telephone_number": "727-656-2245"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL7581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PROVIDER NO.",
            "identifier": "005240000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pembrook Place II Assisted Living Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vianey S. Pelaez, LCSW
• Susan Marie Pelletier, LMT
• Kenneth B Peluso, D.C.
• Kristina Pelzel, PTA
• Pembrook Place 2 Inc
• Pembrook Place Alf Inc.
• Pembrook Place Alf, Inc.
• Edgar Pena, PTA
• Alyssa Penne
• Tamara Pennywell

• Assisted Living Facility in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2014; 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.