MEDICARE: BOPPA'S HOME

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	AL12106	FL

General Provider Information

NPI Number	:	1477999738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOPPA'S HOME

Provider Business Mailing Address
First Line	:	440 CATALINA AVE NW
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32907-1835
Country	:	US
Telephone Number	:	321-327-5350
Fax Number	:	321-327-5350

Provider Business Practice Location Address
First Line	:	440 CATALINA AVE NW
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32907-1835
Country	:	US
Telephone Number	:	321-327-5350
Fax Number	:	321-327-5350

Authorized Official
Title or Position	:	OWNER
Name	:	MS. BETHANN MEYER
Credential	:	RN, BSN
Telephone Number	:	321-327-5350

Provider Enumeration Date	:	05/14/2013
Last Update Date	:	05/14/2013

Similar Medicare Providers

1053778480 — BOPPAS HOME
Practice Location Address:

440 CATALINA AVE NW
PALM BAY, FL
32907-1835

Practice Phone: 321-327-5350
Practice Fax:

1184815797 — ALNA
Practice Location Address:

550 DAVID CIR SW
PALM BAY, FL
32908-1835

Practice Phone: 321-549-4168
Practice Fax:

1194894048 — MRS. JEANNIE LYNN WARREN
Practice Location Address:

3218 PINE FOREST DR
PALM HARBOR, FL
34684-1835

Practice Phone: 618-444-8761
Practice Fax:

1821303975 — MS. MARISSA ALICIA DIAZ
Practice Location Address:

6000 PALM TRACE LANDING DR , APT 204
DAVIE, FL
33314-1835

Practice Phone: 954-854-5532
Practice Fax:

1205872702 — ISLAND SURGICAL GROUP, PC
Practice Location Address:

1835 BAY RIDGE PKWY FL 2
BROOKLYN, NY
11204-5706

Practice Phone: 718-238-6100
Practice Fax: 718-680-7969

1669575882 — STEVEN D RICHARDSON DMD
Practice Location Address:

1835 OCEAN BLVD
COOS BAY, OR
97420

Practice Phone: 541-269-0620
Practice Fax: 541-269-9243

Directions to “BOPPA'S HOME ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.