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NPI Code Detail

MEDICARE: JOHN KNOX VILLAGE OF FLORIDA, INC.

MEDICARE: JOHN KNOX VILLAGE OF FLORIDA, INC.
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
1314000000XSkilled Nursing FacilitySNF1258096FL

Other Identifiers

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

General Provider Information

NPI Number : 1790772127
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHN KNOX VILLAGE OF FLORIDA, INC.
Provider Business Mailing Address
First Line : 700 SW 4TH ST
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33060-7678
Country : US
Telephone Number : 954-247-5800
Fax Number : 954-247-5837
Provider Business Practice Location Address
First Line : 700 SW 4TH ST
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33060-7678
Country : US
Telephone Number : 954-247-5800
Fax Number : 954-247-5837
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : DOUGLAS FOLSOM
Credential :
Telephone Number : 954-783-4096
Provider Enumeration Date : 09/30/2005
Last Update Date : 03/04/2026

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