MEDICARE: THE GLENRIDGE ON PALMER RANCH, 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
1	310400000X	Assisted Living Facility	AL10453	FL
2	314000000X	Skilled Nursing Facility		FL

General Provider Information

NPI Number	:	1902897754
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE GLENRIDGE ON PALMER RANCH, INC.

Provider Business Mailing Address
First Line	:	7333 SCOTLAND WAY
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34238-8530
Country	:	US
Telephone Number	:	941-552-5300
Fax Number	:	941-552-5364

Provider Business Practice Location Address
First Line	:	7390 SCOTLAND WAY
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34238-8514
Country	:	US
Telephone Number	:	941-552-5300
Fax Number	:	941-552-5364

Authorized Official
Title or Position	:	DIRECTOR OF ACCOUNTING SERVICES
Name	:	BARBARA TABOR
Credential	:
Telephone Number	:	941-552-5310

Provider Enumeration Date	:	11/01/2005
Last Update Date	:	09/11/2025

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