MEDICARE: SWAN AT LAKE CONWAY ALF

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
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1962142646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWAN AT LAKE CONWAY ALF

Provider Business Mailing Address
First Line	:	3714 SAINT MORITZ ST
Second Line	:
City	:	BELLE ISLE
State	:	FL
Zip	:	32812-1135
Country	:	US
Telephone Number	:	410-946-4116
Fax Number	:

Provider Business Practice Location Address
First Line	:	3714 SAINT MORITZ ST
Second Line	:
City	:	BELLE ISLE
State	:	FL
Zip	:	32812-1135
Country	:	US
Telephone Number	:	410-946-4116
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BENEYAM TEFERA
Credential	:
Telephone Number	:	410-946-4116

Provider Enumeration Date	:	03/30/2022
Last Update Date	:	12/01/2022

Similar Medicare Providers

1982045753 — SWAN AT LAKE CONWAY
Practice Location Address:

3714 SAINT MORITZ ST
BELLE ISLE, FL
32812-1135

Practice Phone: 407-860-0266
Practice Fax:

1174545735 — DR. RONNIE EUGENE SUGGS DPM
Practice Location Address:

6922 SEMINOLE DR
BELLE ISLE, FL
32812-3713

Practice Phone: 407-240-0002
Practice Fax: 407-240-0088

1134276165 — DR. MICHAEL HENRY HARDS D.D.S.
Practice Location Address:

3525 ADMIRALTY CT
BELLE ISLE, FL
32812-3521

Practice Phone: 407-496-1639
Practice Fax:

1083898928 — DR. KAY T VIEN O.D.
Practice Location Address:

4413 HOFFNER AVE
BELLE ISLE, FL
32812-2331

Practice Phone: 407-207-5310
Practice Fax:

1023260759 — AMY STANGO
Practice Location Address:

3430 CULLEN LAKE SHORE DR
BELLE ISLE, FL
32812

Practice Phone: 215-431-3374
Practice Fax: 407-704-3088

1073804522 — LORI B LARGE
Practice Location Address:

5003 SAINT MARIE AVE
BELLE ISLE, FL
32812-1068

Practice Phone: 419-787-5508
Practice Fax:

Directions to “SWAN AT LAKE CONWAY ALF ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.