MEDICARE: BAYSHORE RESIDENCE ALF

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	261QA0600X	Adult Day Care Clinic/Center	AL750	FL

General Provider Information

NPI Number	:	1497922538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYSHORE RESIDENCE ALF

Provider Business Mailing Address
First Line	:	686 SW LUCERO DR
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34983-1894
Country	:	US
Telephone Number	:	772-871-1106
Fax Number	:	772-871-1104

Provider Business Practice Location Address
First Line	:	686 SW LUCERO DR
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34983-1894
Country	:	US
Telephone Number	:	772-871-1106
Fax Number	:	772-871-1104

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. VIOLET VERONA BURKE7728711106
Credential	:
Telephone Number	:	772-871-1106

Provider Enumeration Date	:	05/08/2008
Last Update Date	:	05/08/2008

Similar Medicare Providers

1023489044 — MEADOW CARE ASSISTED LIVING FACILITY
Practice Location Address:

686 SW LUCERO DR
PORT SAINT LUCIE, FL
34983-1894

Practice Phone: 772-237-5253
Practice Fax:

1689879504 — MRS. DONNA-LEE GIOIA LMT
Practice Location Address:

1894 SE PORT ST LUCIE BLVD
PORT ST LUCIE, FL
34952-5545

Practice Phone: 772-398-1433
Practice Fax:

1427309913 — MS. DENISE ARNIESHA CRAIG M.S
Practice Location Address:

1894 SE GRAND DR
PORT ST LUCIE, FL
34952-7794

Practice Phone: 772-600-6001
Practice Fax:

1629869078 — DANIEL & MAX, LLC
Practice Location Address:

1894 SW GATLIN BLVD
PORT ST. LUCIE, FL
34953

Practice Phone: 877-350-3399
Practice Fax:

1750384467 — MARY BETH LEAN PSY.D.
Practice Location Address:

537 ROUTE 28 , STE 2G
HARWICH PORT, MA
02646-1894

Practice Phone: 508-430-8672
Practice Fax: 508-430-9821

1558571901 — MARIAN D LALEVEE, MS RD CDE LDN LLC
Practice Location Address:

537 ROUTE 28 , PORT CENTRE BLDG., SUITE 2 G
HARWICH PORT, MA
02646-1894

Practice Phone: 508-945-3897
Practice Fax: 508-945-1768

Directions to “BAYSHORE RESIDENCE ALF ” 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.