MEDICARE: FIVE STAR CORAL OAKS LLC

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	AL7368	FL

General Provider Information

NPI Number	:	1205875101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIVE STAR CORAL OAKS LLC

Provider Business Mailing Address
First Line	:	400 CENTRE ST
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02458-2094
Country	:	US
Telephone Number	:	617-796-8387
Fax Number	:	617-796-8385

Provider Business Practice Location Address
First Line	:	900 W LAKE RD
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-3142
Country	:	US
Telephone Number	:	727-787-3333
Fax Number	:	727-784-4886

Authorized Official
Title or Position	:	PRESIDENT & CHIEF EXECUTIVE OFFICER
Name	:	BRUCE J MACKEY JR.
Credential	:
Telephone Number	:	617-796-8214

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	06/27/2016

Similar Medicare Providers

1669980983 — FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC
Practice Location Address:

900 WEST LAKE ROAD
PALM HARBOR, FL
34684-3142

Practice Phone: 727-787-3333
Practice Fax: 727-784-3430

1326695529 — SNH FLA TENANT LLC
Practice Location Address:

900 W LAKE RD
PALM HARBOR, FL
34684-3142

Practice Phone: 727-787-3333
Practice Fax: 727-784-4886

1033834759 — JEANETTE ARAHOOD
Practice Location Address:

900 W LAKE RD
PALM HARBOR, FL
34684-3142

Practice Phone: 727-787-3333
Practice Fax:

1629157656 — MR. ROBERT J HOPKINS PA-C
Practice Location Address:

36181 E LAKE RD # 390
PALM HARBOR, FL
34685-3142

Practice Phone: 727-781-8685
Practice Fax: 727-786-2852

1417036450 — HOPKINS SURGICAL ASSISTANCE, INC.
Practice Location Address:

36181 E LAKE RD # 390
PALM HARBOR, FL
34685-3142

Practice Phone: 727-781-8685
Practice Fax: 727-786-2852

1053596619 — EYES OF PALM HARBOR
Practice Location Address:

36163 E LAKE RD
PALM HARBOR, FL
34685-3142

Practice Phone: 727-787-2645
Practice Fax: 727-787-2680

Directions to “FIVE STAR CORAL OAKS LLC ” 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.