Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shady Lane Retirement Home

Organization Assisted Living Facility · NPI 1114253754

Shady Lane Retirement Home is an Assisted Living Facility in Leesburg, Florida. Licensed in Florida. Registered with an NPI since 2009.

Licensed in
FL
In the registry since
2009

Practice location Address checks out

201 Rosefield Ave
Leesburg, FL 34748-5014
Phone: (352) 728-1559
Fax: (352) 728-1703
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X · Licence AL6001 (FL)

Record details

NPI number1114253754
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Segundo Lizardo — Owner/Administrator · (352) 728-1559
NPI enumeratedNovember 1, 2009
Last updated in NPPESNovember 1, 2009
Mailing address201 Rosefield Ave, Leesburg, FL 34748-5014

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