DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: NIC 4 SOUTHERN GARDENS LEASING LLC

MEDICARE: NIC 4 SOUTHERN GARDENS LEASING 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
1310400000XAssisted Living Facility8937FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710321112
Entity Type Code : Organization
Provider Name (Legal Business Name) : NIC 4 SOUTHERN GARDENS LEASING LLC
Provider Business Mailing Address
First Line : 255 E MAIN ST
Second Line :
City : LAKE ALFRED
State : FL
Zip : 33850-2133
Country : US
Telephone Number : 212-479-5343
Fax Number :
Provider Business Practice Location Address
First Line : 255 E MAIN ST
Second Line :
City : LAKE ALFRED
State : FL
Zip : 33850-2133
Country : US
Telephone Number : 212-479-5343
Fax Number :
Authorized Official
Title or Position : CFO
Name : MR. BRIAN SIGMAN
Credential :
Telephone Number : 212-479-5343
Provider Enumeration Date : 04/29/2013
Last Update Date : 04/29/2013

Similar Medicare Providers

1285751370 — SOUTHERN GARDENS, LLC
Practice Location Address:
255 E MAIN ST
LAKE ALFRED, FL
33850-2133
Practice Phone: 863-956-0411
Practice Fax: 863-956-0164
1760857759 — TARA WOODWARD PTA
Practice Location Address:
255 E MAIN ST
LAKE ALFRED, FL
33850-2133
Practice Phone: 863-956-0411
Practice Fax:
1194275628 — ANDREA DON REXROAD PTA
Practice Location Address:
255 E MAIN ST
LAKE ALFRED, FL
33850-2133
Practice Phone: 863-956-0411
Practice Fax:
1275048407 — SHERI ANNETTE FOLLIS PTA
Practice Location Address:
255 E MAIN ST
LAKE ALFRED, FL
33850-2133
Practice Phone: 863-662-5690
Practice Fax: 863-662-5756
1356909642 — SOUTHERN GARDENS FL AL MANAGEMENT LLC
Practice Location Address:
255 E MAIN ST
LAKE ALFRED, FL
33850-2133
Practice Phone: 863-956-0411
Practice Fax:
1841846300 — JEFF GALLICHAN PTA
Practice Location Address:
255 E MAIN ST
LAKE ALFRED, FL
33850-2133
Practice Phone: 727-803-1102
Practice Fax:

Directions to “NIC 4 SOUTHERN GARDENS LEASING 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.