SOUTHERN LIVE IN OF BRANDON (NPI# 1831489632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831489632 |
| Entity Type | Organization |
| Organization Name | SOUTHERN LIVE IN OF BRANDON |
| Practice Address |
619 Princeton St Brandon FL 33511-7129 |
| Mailing Address |
Po Box 3528 Apollo Beach FL 33572-1005 |
| Practice Telephone | 8136550822 |
| Practice Fax Number | 8136811482 |
| Mailing Telephone | 8136550822 |
| Mailing Fax Number | 8136811482 |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2011-04-13 |
| Authorized Official Name | ELONIE MARIE BESSETTE (ADMINISTRATOR) |
| Authorized Official Telephone | 8136550822 |
| Authorized Official Credential | LPN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL9890 | FL | Nursing & Custodial Care Facilities |
| Street Address |
619 PRINCETON ST |
| City | BRANDON |
| State | FL |
| Zip Code | 33511-7129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194140566 | Meloine Bessette | Licensed Practical Nurse | 619 Princeton St, Brandon, FL 33511-7129 | 2014-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295367555 | Ability Beyond Measures LLC. | Clinic/Center | 2705 Isabella Valley Court, Brandon, FL 33511 | 2020-02-05 |
| 1831744655 | Brandon Modern Dentistry, Pa | Dentist | 971 E. Bloomingdale Avenue, Brandon, FL 33511 | 2019-08-08 |
| 1487208922 | Heart and Vascular Center of Brandon, Pllc | Internal Medicine | 511 Medical Oaks Ave., Brandon, FL 33511 | 2019-08-01 |
| 1841842895 | Rebecca Harrelson | Counselor | 915 Oakfield Drive, Suite E, Brandon, FL 33511 | 2019-07-10 |
| 1043779713 | Cheryl Diane Hart | Nurse Practitioner | 888 S Parsons Ave., Brandon, FL 33511 | 2019-03-13 |
| 1306303177 | Paula J Buchwald | Nurse Practitioner | 888 S. Parsons Ave, Brandon, FL 33511 | 2019-02-27 |
| 1063993996 | Ashlee Marie Shevchenko | Speech-Language Pathologist | 602 Vondeburg Dr, Suite 201, Brandon, FL 33511 | 2018-08-28 |
| 1275023012 | Ava Cares, LLC | Assisted Living Facility | 3005 Bell Shoals Rd., Brandon, FL 33511 | 2018-05-17 |
| 1346738705 | Tampa Psychology Group | Psychologist | 1463 Oakfield Dr Ste 109, Brandon, FL 33511 | 2018-05-01 |
| 1760982987 | Suresh Lama Tamang | Counselor | 510 Vonderburg Dr, Suite# 301, Brandon, FL 33511 | 2018-02-14 |
| Find all providers in zip 33511 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104318435 | Park View of Brandon LLC | Assisted Living Facility | 1502 Bryan Rd, Brandon, FL 33511-6835 | 2018-06-01 |
| 1275023012 | Ava Cares, LLC | Assisted Living Facility | 3005 Bell Shoals Rd., Brandon, FL 33511 | 2018-05-17 |
| 1700395613 | Senior Living Properties Iv, LLC | Assisted Living Facility | 824 N Parsons Ave, Brandon, FL 33510-3435 | 2017-09-22 |
| 1518482462 | Ava Cares, LLC | Assisted Living Facility | 713 Pearl Circle, Brandon, FL 33510 | 2017-08-11 |
| 1013432723 | Brisas Del Caribe Alf | Assisted Living Facility | 2203 Shermont Place, Brandon, FL 33511 | 2017-08-03 |
| 1396269049 | Milagros Carreno | Assisted Living Facility | 2203 Shermont Pl, Brandon, FL 33511-6935 | 2017-08-02 |
| 1003364183 | Living Well Senior Care | Assisted Living Facility | 2006 Wrangler Dr, Brandon, FL 33511-2121 | 2016-09-16 |
| 1497202576 | Brandon Bg Opco LLC | Assisted Living Facility | 700 S Kings Ave, Brandon, FL 33511-5925 | 2016-09-06 |
| 1699143354 | Whispering Willows, Alf | Assisted Living Facility | 3005 Bell Shoals Rd, Brandon, FL 33511-7613 | 2015-09-10 |
| 1942693395 | Ava Cares LLC | Assisted Living Facility | 616 Valle Vista Dr, Brandon, FL 33511-7830 | 2015-03-10 |
| Find all providers in BRANDON | ||||
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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.