=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699113761
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SLOAN HOME OF CENTRAL FLORIDA INC. II
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/11/2013
-----------------------------------------------------
Last Update Date | 06/11/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 505 HARBOR POINT BLVD
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32835-1845
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 321-663-9537
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 505 HARBOR POINT BLVD
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32835-1845
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. DEVIKA ESARDIAL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 321-663-9537
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------