1059 Virginia St Opco LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

1059 VIRGINIA ST OPCO LLC

Doing business as

Aviata at Lakeside Oaks Villas

Practice address

1059 Virginia St
Dunedin, FL 34698-7326

Phone

(727) 733-6091

Fax

(727) 736-6739

NPI assigned

Oct 30, 2023

Last updated

Apr 9, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nathan Freund

Title

Manager

Phone

(732) 730-7480

Specialties & licenses 1

Addresses

Other names 1

• Aviata at Lakeside Oaks Villas Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1698624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1982476206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1059 VIRGINIA ST",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346987326",
            "telephone_number": "727-733-6091",
            "fax_number": "727-736-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1059 VIRGINIA ST",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346987326",
            "telephone_number": "727-733-6091",
            "fax_number": "727-736-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1059 VIRGINIA ST OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-30",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A",
        "authorized_official_last_name": "FREUND",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "732-730-7480"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.5042",
            "affiliationName": "Consulate Health Care",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "850 Concourse Pkwy S Ste 250",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327516155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Aviata at Lakeside Oaks Villas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 1061 Virginia St Opco LLC (Aviata at Lakeside Oaks)
• 1061 Virginia Street Operations LLC (Lakeside Oaks Care Center)
• 1330 LLC
• 1351 Golden LLC (Cross Terrace Care Center)
• 1351 Management LLC (Cross Terrace Rehabilitation Center)

• Assisted Living Facility in Dunedin, FL
• Providers in Dunedin, 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 Apr 9, 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.