Florida Care Alf of Amelia Island Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

FLORIDA CARE ALF OF AMELIA ISLAND INC

Practice address

1550 Nectarine St
Fernandina Beach, FL 32034-3030

Phone

(954) 461-7435

NPI assigned

Jun 11, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Joseph V Mondelli Jr.

Title

President

Phone

(954) 461-7435

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• AMELIA SPRINGS ASSISTED LIVING Doing business as

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1891363362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7432 WILES RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330672066",
            "telephone_number": "954-461-7435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 NECTARINE ST",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343030",
            "telephone_number": "954-461-7435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA CARE ALF OF AMELIA ISLAND INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "MONDELLI",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-461-7435",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053704965",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMELIA SPRINGS ASSISTED LIVING",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AMELIA SPRINGS ASSISTED LIVING",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Fernandina Beach, FL
• Providers in Fernandina Beach, 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 Aug 24, 2021; 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.