Market Street East Lake SL, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MARKET STREET EAST LAKE SL, LLC

Practice address

833 E Lake Rd N
Tarpon Springs, FL 34688-6308

Phone

(727) 202-9314

NPI assigned

Aug 15, 2019

Organization subpart

No

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

Authorized official

Name

Joan Williams

Title

Manager and Cfo

Phone

(772) 539-4560

Specialties & licenses 1

Addresses

Other names 1

• Market Street East Lake Doing business as

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565827200000",
    "number": "1902452964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 24TH ST STE 300",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329607502",
            "telephone_number": "772-539-4560",
            "fax_number": "772-257-6934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 E LAKE RD N",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346886308",
            "telephone_number": "727-202-9314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARKET STREET EAST LAKE SL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-15",
        "last_updated": "2019-08-15",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "MANAGER AND CFO",
        "authorized_official_telephone_number": "772-539-4560"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Market Street East Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Matthew Maister, R.PH.
• Michael R. Marcell I, D.C.
• Jessica Leigh Marchand
• Marcus Occhipinti MD PA
• Marina V Kulick MD PLC
• James Robert Marone, PA-C
• Jaime Marshall, CRNA, APRN
• Deirdre K Martin, LMHC
• Errol R Martin, RPT
• Elizabeth Martino, MD

• Assisted Living Facility in Tarpon Springs, FL
• Providers in Tarpon Springs, 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 15, 2019; 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.