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NPI Code Detail

MEDICARE: HEARTLAND OF JACKSONVILLE FL LLC

MEDICARE: HEARTLAND OF JACKSONVILLE FL 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
1314000000XSkilled Nursing FacilitySNF1207095FL

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 : 1881641454
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEARTLAND OF JACKSONVILLE FL LLC
Provider Business Mailing Address
First Line : 333 N SUMMIT ST
Second Line :
City : TOLEDO
State : OH
Zip : 43604-2615
Country : US
Telephone Number : 419-252-5500
Fax Number : 877-385-9446
Provider Business Practice Location Address
First Line : 8495 NORMANDY BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32221-6701
Country : US
Telephone Number : 904-783-3794
Fax Number : 904-693-9137
Authorized Official
Title or Position : DIRECTOR
Name : MR. MARTIN D ALLEN
Credential :
Telephone Number : 419-252-5734
Provider Enumeration Date : 05/28/2006
Last Update Date : 06/16/2017

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Directions to “HEARTLAND OF JACKSONVILLE FL LLC ” Practice Location

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