Organization
BRIDGEPORT SENIOR LIVING - PORT ISLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN GALBASINI (MANAGING PARTNER)
(407) 760-3649
Entity
Organization
Contact information
Practice address
13506 SUMMERPORT VILLAGE PKWY, 129, WINDERMERE, FL 34786-7366
(407) 203-0868
Mailing address
13506 SUMMERPORT VILLAGE PKWY, 129, WINDERMERE, FL 34786-7366
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12372
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083957039
—
FL
Enumeration date
07/22/2013
Last updated
07/22/2013
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