MEDICARE: KINDRED HOSPITALS EAST, 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	282N00000X	General Acute Care Hospital
2	282E00000X	Long Term Care Hospital	4440	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
2	Y01	OTHER	FL	BLUE CROSS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861577306
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINDRED HOSPITALS EAST, LLC

Provider Business Mailing Address
First Line	:	1516 E LAS OLAS BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33301-2346
Country	:	US
Telephone Number	:	954-764-8900
Fax Number	:	954-522-1971

Provider Business Practice Location Address
First Line	:	1516 E LAS OLAS BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33301-2346
Country	:	US
Telephone Number	:	954-764-8900
Fax Number	:	954-522-1971

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JOHNETTA TRAYLOR
Credential	:
Telephone Number	:	502-596-6063

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	09/18/2025

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