MEDICARE: SUNLAND-VERO BEACH, 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	314000000X	Skilled Nursing Facility	SNF1486096	FL

General Provider Information

NPI Number	:	1497746515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNLAND-VERO BEACH, LLC

Provider Business Mailing Address
First Line	:	2180 10TH AVE
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-5399
Country	:	US
Telephone Number	:	772-567-5166
Fax Number	:

Provider Business Practice Location Address
First Line	:	2180 10TH AVE
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-5399
Country	:	US
Telephone Number	:	772-567-5166
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE
Name	:	MICHELLE BURDETTE
Credential	:
Telephone Number	:	423-308-1845

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	10/26/2007

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