Healthcare Provider Details

I. General information

NPI: 1942909908
Provider Name (Legal Business Name): APOPKA SOUTH SNF OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2023
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3355 E SEMORAN BLVD
APOPKA FL
32703-6062
US

IV. Provider business mailing address

267 BROADWAY
BROOKLYN NY
11211-6216
US

V. Phone/Fax

Practice location:
  • Phone: 407-862-6263
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: SOLOMON KLEIN
Title or Position: CEO
Credential:
Phone: 347-909-1811