TUCAWILLA VILLA, LLC (NPI# 1225499817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225499817 |
| Entity Type | Organization |
| Organization Name | TUCAWILLA VILLA, LLC |
| Practice Address |
995 Tuscawilla Road Winter Springs FL 32708 |
| Practice Telephone | 4076370273 |
| Mailing Telephone | 4076370273 |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2016-03-10 |
| Authorized Official Name | JAMIE M HARRY (OWNER/ADMINISTRATOR) |
| Authorized Official Telephone | 4076370273 |
| Authorized Official Credential | RN/RD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
6906719 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BUSINESS TAX RECEIPT- FLORIDA DIVISION OF CORPORATION | 213000110783 | 01 |
| FL | AHCA LICENSE FOR ADULT FAMILY CARE HOME- | 6906719 | 01 |
| Street Address |
995 TUSCAWILLA ROAD |
| City | WINTER SPRINGS |
| State | FL |
| Zip Code | 32708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558928853 | Veronica-jo Prisco | Social Worker | 580 Old Sanford Road, Winter Springs, FL 32708 | 2019-05-22 |
| 1083101398 | Kd Medical Choice Inc | Clinical Medical Laboratory | 253 Winding Hollow Blvd, Winter Springs, FL 32708 | 2018-04-23 |
| 1861921223 | Karen Bova | Nurse Practitioner | 427 S. Buckskin Way, Winter Springs, FL 32708 | 2017-06-08 |
| 1922530997 | Mayur Vibhakar | Pharmacist | 5840 Red Bug Lake Rd # 1532, Winter Springs, FL 32708 | 2017-03-29 |
| 1053855379 | Liadys Diaz | Social Worker | 4 Sycamore Ct Apt 102, Winter Springs, FL 32708 | 2016-12-05 |
| 1508222100 | Elizabeth Wright | Occupational Therapist | 985 Troon Trce, Winter Springs, FL 32708 | 2016-01-12 |
| 1790168771 | K Rose Ivey | Counselor | 252 Saxony Ct, Winter Springs, FL 32708 | 2015-07-08 |
| 1568863165 | Charles Afton Wise | Counselor | 1491 East Sr 434, Suite 104, Winter Springs, FL 32708 | 2014-09-15 |
| 1174958342 | Jorge Deju | Preventive Medicine | 617 Nighthawk Circle, Winter Springs, FL 32708 | 2013-09-06 |
| 1073952875 | Digmory Lizzie Adair | Occupational Therapist | 701 Alton Road, Winter Springs, FL 32708 | 2013-06-14 |
| Find all providers in zip 32708 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
| City | WINTER SPRINGS |
| Zip Code | 32708 |
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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.