PARKSIDE ASSISTED LIVING AND MEMORY COTTAGE (NPI# 1871006734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871006734 |
| Entity Type | Organization |
| Organization Name | PARKSIDE ASSISTED LIVING AND MEMORY COTTAGE |
| Practice Address |
2595 Harbor Blvd Port Charlotte FL 33952-6724 |
| Mailing Address |
Po Box 496420 Port Charlotte FL 33949-6420 |
| Practice Telephone | 9417667444 |
| Practice Fax Number | 9419795884 |
| Mailing Telephone | 9416292111 |
| Mailing Fax Number | 9416275377 |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2017-11-14 |
| Authorized Official Name | DR. SAKINA KHALIDI (OWNER) |
| Authorized Official Telephone | 9416292111 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL13075 | FL | Nursing & Custodial Care Facilities |
| Street Address |
2595 HARBOR BLVD |
| City | PORT CHARLOTTE |
| State | FL |
| Zip Code | 33952-6724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851310080 | Thomas R Civitella | Ophthalmology | 2595 Harbor Blvd, Suite 207, Port Charlotte, FL 33952-6724 | 2006-07-19 |
| 1790707024 | Eric Allan Nash | Ophthalmology | 2595 Harbor Blvd, Suite 207, Port Charlotte, FL 33952-6724 | 2006-07-24 |
| 1487676714 | James H Tietsworth | Ophthalmology | 2595 Harbor Blvd, Suite 207, Port Charlotte, FL 33952-6724 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700486552 | Arrow Medical LLC | Durable Medical Equipment & Medical Supplies | 3514 Tamiami Trail, Unit 104, Port Charlotte, FL 33952 | 2020-10-30 |
| 1376009621 | David Alan Mowry | Massage Therapist | 3148 Whiting Lane, Port Charlotte, FL 33952 | 2019-02-12 |
| 1124527189 | Aegis Group Practice, LLC | Physical Therapist | 2500 Aaron Street, Port Charlotte, FL 33952 | 2018-02-06 |
| 1255856118 | All Powered Mobility, LLC | Durable Medical Equipment & Medical Supplies | 2765 Tamiami Trl Ste B1, Port Charlotte, FL 33952 | 2017-08-11 |
| 1366994915 | Julianne Kumar | Physical Medicine & Rehabilitation | 4166 Tamiami Trail, Unit A, Port Charlotte, FL 33952 | 2016-10-31 |
| 1659729549 | The Gathering Place LLC | Licensed Practical Nurse | 3459 Depew Ave, Port Charlotte, FL 33952 | 2016-06-01 |
| 1003222183 | Philip Lagamma | Physical Therapist | 4161 Tamiami Trl Ste 103, Port Charlotte, FL 33952 | 2014-07-09 |
| 1184039695 | Nathan E Shipley | Driver | 2338 Alton Rd., Port Charlotte, FL 33952 | 2014-06-23 |
| 1619318219 | Nic 4 Royal Palm Leasing LLC | Assisted Living Facility | 2500 Aaron St., Port Charlotte, FL 33952 | 2013-07-11 |
| 1225306475 | Tamjo Inc | Hearing Instrument Specialist | 2811 Ste. A Tamiami Trail, Port Charlotte, FL 33952 | 2011-12-02 |
| Find all providers in zip 33952 | ||||
| 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 |
|---|---|---|---|---|
| 1891331427 | Bubbsh LLC | Assisted Living Facility | 370 Blarney St, Port Charlotte, FL 33954-3751 | 2019-11-19 |
| 1619318219 | Nic 4 Royal Palm Leasing LLC | Assisted Living Facility | 2500 Aaron St., Port Charlotte, FL 33952 | 2013-07-11 |
| 1811331283 | Nic 4 Village Place Leasing LLC | Assisted Living Facility | 18400 Cochran Blvd., Port Charlotte, FL 33948 | 2013-04-29 |
| 1841533122 | Royal Palm Retirement, LLC | Assisted Living Facility | 2500 Aaron St, Port Charlotte, FL 33952-6743 | 2013-04-04 |
| 1194090803 | Family Home Care II, Inc. | Assisted Living Facility | 1222 Zinnea St, Port Charlotte, FL 33952-1538 | 2012-03-13 |
| 1164791497 | Caring Hearts Alf | Assisted Living Facility | 21000 Midway Blvd, Port Charlotte, FL 33952-2451 | 2011-12-15 |
| 1861775603 | Snh Se Tenant Trs, Inc | Assisted Living Facility | 20480 Veterans Blvd, Port Charlotte, FL 33954-2264 | 2011-09-27 |
| 1851695399 | Family Extended Care of Punta Gorda, Inc | Assisted Living Facility | 22332 Vick St, Port Charlotte, FL 33980-2053 | 2010-12-24 |
| 1245532621 | Brookdale Senior Living Communities, Inc. | Assisted Living Facility | 18440 Cochran Blvd, Port Charlotte, FL 33948-3339 | 2010-11-17 |
| 1245436773 | Port Charolette Alf, LLC | Assisted Living Facility | 18400 Cochran Blvd, Port Charlotte, FL 33948-3343 | 2007-06-22 |
| Find all providers in PORT CHARLOTTE | ||||
| City | PORT CHARLOTTE |
| Zip Code | 33952 |
Please comment or provide details below to improve the information on PARKSIDE ASSISTED LIVING AND MEMORY COTTAGE.
| 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.