MEDICARE: SURREY PLACE OF LACANTO 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		FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588665251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURREY PLACE OF LACANTO LLC

Provider Business Mailing Address
First Line	:	2123 CENTRE POINTE BLVD
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-4930
Country	:	US
Telephone Number	:	850-386-2831
Fax Number	:	850-386-2016

Provider Business Practice Location Address
First Line	:	2730 W MARC KNIGHTON CT
Second Line	:
City	:	LECANTO
State	:	FL
Zip	:	34461-8334
Country	:	US
Telephone Number	:	352-746-9500
Fax Number	:	352-746-9666

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOSEPH D. MITCHELL
Credential	:
Telephone Number	:	850-386-2831

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	03/18/2014

Similar Medicare Providers

1679963938 — DR. LOUIS L. ORR IV PSYD
Practice Location Address:

2804 W MARC KNIGHTON CT , SUITE A
LECANTO, FL
34461-8334

Practice Phone: 352-746-8067
Practice Fax: 352-746-8069

1740894690 — MARIA LEZCANO TOMMOLINO APRN
Practice Location Address:

1990 N PROSPECT AVE
LECANTO, FL
34461-9792

Practice Phone: 352-527-6888
Practice Fax:

1245230044 — DR. LEE ELMA HOWELL JR. M.D.
Practice Location Address:

2804 W MARC KNIGHTON CT
LECANTO, FL
34461-6300

Practice Phone: 352-746-8000
Practice Fax: 352-746-8003

1588665632 — EILEEN SNYDER NURSE PRACTITIONER
Practice Location Address:

2653 N LECANTO HWY
LECANTO, FL
34461-9679

Practice Phone: 352-527-9555
Practice Fax:

1073507455 — DR. MARGARET ANNE COLLINS MD
Practice Location Address:

525 N DACIE PT
LECANTO, FL
34461-8399

Practice Phone: 352-746-2200
Practice Fax: 352-746-9320

1104810563 — DR. RALPH EUGENE MASSULLO JR. MD
Practice Location Address:

525 N DACIE PT
LECANTO, FL
34461-8399

Practice Phone: 352-746-2200
Practice Fax: 352-746-9320

Directions to “SURREY PLACE OF LACANTO 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.