Pacifica BG Mabry LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PACIFICA BG MABRY LLC

Practice address

16702 N. Dale Mabry Highway
Tampa, FL 33618-1055

Phone

(813) 908-2333

Fax

(813) 908-3528

NPI assigned

Sep 1, 2022

Organization subpart

No

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

Authorized official

Name

Deepak Israni

Title

General Manager

Phone

(619) 296-9000

Specialties & licenses 2

Addresses

Other names 1

• Tampa Gardens Senior Living Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661990400000",
    "number": "1831819523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 HANCOCK STREET",
            "address_2": "SUITE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92110",
            "telephone_number": "619-296-9000",
            "fax_number": "619-296-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16702 N. DALE MABRY HIGHWAY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336181055",
            "telephone_number": "813-908-2333",
            "fax_number": "813-908-3528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFICA BG MABRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A",
        "authorized_official_last_name": "ISRANI",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "619-296-9000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tampa Gardens Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Ann Pacheco, LMHC
• Lindsay L Pacheco, APRN
• Mayrobis Pacheco
• Sarina Pacheco
• Brian S Pachmayer, MD
• Pacifica Home Care Corp
• Pacifica Services, Inc.
• Catherine Paciotti, MD
• Christina A Padalia, PA-C
• Devang M Padalia, MD

• Assisted Living Facility in Tampa, FL
• Providers in Tampa, 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 Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.