Shady Lane Retirement Home
NPI 1114253754 · Assisted Living Facility · Leesburg, FL
Shady Lane Retirement Home is a Assisted Living Facility organization in Leesburg, FL (NPI 1114253754).
Provider details
- NPI number
- 1114253754
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Segundo Lizardo, Owner/Administrator(352) 728-1559
- License
- AL6001 (FL)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2009-11-01
- Last updated
- 2009-11-01
Frequently asked questions
- What is Shady Lane Retirement Home's NPI number?
- Shady Lane Retirement Home's National Provider Identifier (NPI) is 1114253754, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Shady Lane Retirement Home?
- Shady Lane Retirement Home is classified in the NPPES registry as Assisted Living Facility (Nursing & Custodial Care Facilities).
- Where is Shady Lane Retirement Home located?
- Shady Lane Retirement Home's practice location on file with NPPES is 201 Rosefield Ave, Leesburg, FL 34748-5014.
- What is Shady Lane Retirement Home's phone number?
- The practice phone number listed in the NPPES registry for Shady Lane Retirement Home is (352) 728-1559.
- Who is the authorized official for Shady Lane Retirement Home?
- The authorized official listed on Shady Lane Retirement Home's NPPES record is Segundo Lizardo, Owner/Administrator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Shady Lane Retirement Home's NPI active?
- Yes — Shady Lane Retirement Home's NPI (1114253754) is active in the NPPES registry as of the last update on 2009-11-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.