FLORIDA MENTOR II LLC (NPI# 1093322794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093322794 |
| Entity Type | Organization |
| Organization Name | FLORIDA MENTOR II LLC |
| Practice Address |
14219 Bruce B Downs Blvd Tampa FL 33613-3913 |
| Mailing Address |
3258 Parkside Center Cir Tampa FL 33619-0907 |
| Practice Telephone | 8139713490 |
| Practice Fax Number | 8139773471 |
| Mailing Telephone | 8133898300 |
| Enumeration Date | 2020-09-26 |
| Last Update Date | 2020-10-01 |
| Authorized Official Name | CAROL SWANSON (VICE PRESIDENT OF OPERATIONS) |
| Authorized Official Telephone | 8133898300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962009019 | Florida Mentor II LLC | Intermediate Care Facility, Mentally Retarded | 1045 Mar Walt Dr, Fort Walton Beach, FL 32547-6738 | 2020-10-01 |
| 1144827288 | Florida Mentor II LLC | Intermediate Care Facility, Mentally Retarded | 455 Appleyard Dr, Tallahassee, FL 32304-2808 | 2020-10-01 |
| 1780281824 | Florida Mentor II LLC | Intermediate Care Facility, Mentally Retarded | 1 Villa Dr, Pensacola, FL 32506-5535 | 2020-10-01 |
| 1144827296 | Florida Mentor II LLC | Intermediate Care Facility, Mentally Retarded | 1407 Lincoln Dr, Panama City, FL 32401-2870 | 2020-10-01 |
| Street Address |
14219 BRUCE B DOWNS BLVD |
| City | TAMPA |
| State | FL |
| Zip Code | 33613-3913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841299237 | Pensacola Care, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 14219 Bruce B Downs Blvd, Tampa, FL 33613-3913 | 2005-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649877671 | Lisandra Isabelle Raba | Behavior Technician | 3299 Usf Banyan Circle, Tampa, FL 33613 | 2020-10-02 |
| 1184250490 | Stetho Md LLC | Family Medicine | 1707 E Bearss Ave, Tampa, FL 33613 | 2020-03-18 |
| 1174187645 | Renee Pinheiro | Student in an Organized Health Care Education/Training Program | Usf Health Morsani College of Medicine, 12901 Bruce B Downs Blvd. Mdc5, Tampa, FL 33613 | 2019-04-30 |
| 1104388842 | Heartbeat Home Health Care LLC | Home Health | 13542 N Florida Ave Ste 209-b, Tampa, FL 33613 | 2019-04-02 |
| 1437625357 | Carierx LLC | Pharmacy | 15511 N. Florida Avenue, Ste 601, Tampa, FL 33613 | 2018-10-18 |
| 1205312980 | Sabina Vlaeva | Dentist | Affordable Dentures & Implants, 14936 N Florida Avenue Ste 101, Tampa, FL 33613 | 2018-07-16 |
| 1780170266 | Joy M. Alexander | Driver | 14209 Cyber Pl Apt 102, Tampa, FL 33613 | 2018-07-08 |
| 1598289829 | Lillian Perez | Social Worker | 13542 N Florida Avenue, Suite 210, Tampa, FL 33613 | 2017-07-28 |
| 1134640386 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3100 E Fletcher Ave Ste A165, Tampa, FL 33613 | 2017-06-28 |
| 1770016099 | Marcus Bruno | Physician Assistant | 13701 Bruce B Downs Blvd., Tampa, FL 33613 | 2017-04-04 |
| Find all providers in zip 33613 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962009019 | Florida Mentor II LLC | Intermediate Care Facility, Mentally Retarded | 1045 Mar Walt Dr, Fort Walton Beach, FL 32547-6738 | 2020-10-01 |
| 1952919557 | The Vinglo House LLC | Intermediate Care Facility, Mentally Retarded | 1862 Finn Hill Dr, Boynton Beach, FL 33426-9329 | 2020-07-20 |
| 1487290730 | Noal Group Home, Inc | Intermediate Care Facility, Mentally Retarded | 13379 Key Lime Blvd, West Palm Beach, FL 33412-2150 | 2019-11-21 |
| 1770055980 | National Mentor Healthcare LLC | Intermediate Care Facility, Mentally Retarded | 1275 N Rainbow Loop, Lecanto, FL 34461-8893 | 2018-12-28 |
| 1871993899 | Diomar Anover | Intermediate Care Facility, Mentally Retarded | 17812 Wendy Sue Ave, Hudson, FL 34667-5917 | 2014-08-27 |
| 1972856011 | The Mentor Network | Intermediate Care Facility, Mentally Retarded | 1725 Fifth St, Daytona Beach, FL 32117-5107 | 2012-10-25 |
| 1366798290 | Barc Housing Inc. | Intermediate Care Facility, Mentally Retarded | 2750 Sw 75th Ave, Davie, FL 33314-1008 | 2012-07-30 |
| 1255658365 | 98 | Intermediate Care Facility, Mentally Retarded | 11314 Mahopac Rd, Weeki Wachee, FL 34614-3562 | 2010-04-28 |
| 1245404250 | Marcia A. Howell | Intermediate Care Facility, Mentally Retarded | 17305 Blooming Fields Dr, Land O Lakes, FL 34638-7222 | 2008-04-22 |
| 1497928774 | New Vue LLC Dba Key Pine Village | Intermediate Care Facility, Mentally Retarded | 6457 W Norvell Bryant Hwy, Crystal River, FL 34429-9413 | 2008-04-08 |
| 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.