MS. JACQUELINE GALE MCGORDON (NPI# 1063720787) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063720787 |
| Entity Type | Individual |
| Full Name | MS. JACQUELINE GALE MCGORDON |
| Practice Address |
1038 N Walker Ave Lakeland FL 33805-4276 |
| Mailing Address |
828 W 2nd St Lakeland FL 33805-4226 |
| Practice Telephone | 8636889776 |
| Practice Fax Number | 8636889776 |
| Mailing Telephone | 8636889776 |
| Mailing Fax Number | 8636880675 |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2011-08-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
6906490 | FL | Nursing & Custodial Care Facilities |
| Street Address |
1038 N WALKER AVE |
| City | LAKELAND |
| State | FL |
| Zip Code | 33805-4276 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477188704 | Ernie Tairon Lugo | Nursing Home Administrator | 5210 State Road N 33, Lot 8, Lakeland, FL 33805 | 2020-03-06 |
| 1912546631 | Francis Esperanzate | Physical Therapist | 5070 Menlo Parke Way, Lakeland, FL 33805 | 2019-12-27 |
| 1689232514 | Anointed Touch | Home Health | 617 S Robson Street, Lakeland, FL 33805 | 2019-06-05 |
| 1083160642 | Cherlande Pierre | Chiropractor | 1507 Lakeland Hills Blvd Ste 109, Lakeland, FL 33805 | 2016-09-01 |
| 1992251706 | Damaris Salmeron | Physical Therapy Assistant | 3127 Us Hwy 98 N, Lakeland, FL 33805 | 2016-08-31 |
| 1831589076 | Sarah Mcneill | Pharmacist | 3124 Lakeland Hills Blvd, Lakeland, FL 33805 | 2015-01-26 |
| 1750706479 | Alison M Busby | Counselor | Achievement Academy Inc, 716 E. Bella Vista St, Lakeland, FL 33805 | 2014-03-04 |
| 1174872907 | William Vargas, M.d. P. A. | Anesthesiology | 202 Parkview Place, Lakeland, FL 33805 | 2012-09-07 |
| 1184998056 | Eduardo Francisco Lopez Garcia | Internal Medicine | 135 E First Street, Lakeland, FL 33805 | 2012-02-24 |
| 1255625513 | Navdeep Singh Jassal | Physical Medicine & Rehabilitation | 1417 Lakeland Hills Blvd Ste 201, Lakeland, FL 33805 | 2011-06-04 |
| Find all providers in zip 33805 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396225249 | Detra Morrison | Custodial Care Facility | 5440 Old Highway 37, Lakeland, FL 33811-2331 | 2018-08-20 |
| 1386005841 | Johnsons Gates LLC | Custodial Care Facility | 2736 W 10th St, Lakeland, FL 33805-3982 | 2016-03-11 |
| 1396102554 | Faison Health Care Solution | Custodial Care Facility | 2064 View Point Landings Rd, Lakeland, FL 33810 | 2016-01-19 |
| 1780086553 | Judith Barret Douglas | Custodial Care Facility | 3988 Hampton Hills Dr, Lakeland, FL 33810-3841 | 2014-09-23 |
| 1629181391 | Cathy's Adult Family Care Home | Custodial Care Facility | 420 El Dorado St, Lakeland, FL 33809-4284 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497243 | Two Kinds of Hearts 'llc' | Custodial Care Facility | 1808 Oak Pond Street, Ruskin, FL 33570 | 2020-11-03 |
| 1881293843 | Inspire Family Home Care LLC. | Custodial Care Facility | 566 Forsyth Creek Ct, Apopka, FL 32712-3318 | 2020-10-21 |
| 1336747658 | Eddrena Thornton | Custodial Care Facility | 2233 Bluebird Ave, Bartow, FL 33830-2953 | 2020-10-09 |
| 1689280083 | Wendy Del Rosario Toledo Machado | Custodial Care Facility | 7101 Green St, New Port Richey, FL 34652-1630 | 2020-09-21 |
| 1568077469 | Titilayo M Dipe | Custodial Care Facility | 11215 Gold Compass St, Gibsonton, FL 33534-5698 | 2020-09-09 |
| 1124630892 | Moselene Belizaire | Custodial Care Facility | 3411 9th St W, Lehigh Acres, FL 33971-5357 | 2020-08-23 |
| 1396354395 | Unique Adult Family Care Home Inc. | Custodial Care Facility | 7149 Glenwood Dr, Boynton Beach, FL 33436-9404 | 2020-07-24 |
| 1790301687 | Nancy Isidor | Custodial Care Facility | 1728 Burnham Ct, Clermont, FL 34714-8048 | 2020-06-17 |
| 1326662206 | Yuwaret Haines | Custodial Care Facility | 13566 Rudi Loop, Spring Hill, FL 34609-7964 | 2020-06-05 |
| 1245854686 | Yves Carmen Dorsainvil | Custodial Care Facility | 631 Sw Sardinia Ave, Port Saint Lucie, FL 34953-3746 | 2020-06-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.