MEDICARE: 1351 MANAGEMENT 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

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	:	1851309439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	1351 MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	4700 SHERIDAN ST
Second Line	:	SUITE B
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3420
Country	:	US
Telephone Number	:	954-367-4563
Fax Number	:	954-367-4564

Provider Business Practice Location Address
First Line	:	1351 SAN CHRISTOPHER DR
Second Line	:
City	:	DUNEDIN
State	:	FL
Zip	:	34698-5402
Country	:	US
Telephone Number	:	727-736-1421
Fax Number	:	727-738-2765

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MS. MARGARET H FERNANDEZ
Credential	:
Telephone Number	:	954-367-4563

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	11/17/2008

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Directions to “1351 MANAGEMENT LLC ” Practice Location

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