Healthcare Provider Details

I. General information

NPI: 1295449981
Provider Name (Legal Business Name): M OAKS OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2023
Last Update Date: 06/07/2024
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 E COMMERCIAL BLVD
FORT LAUDERDALE FL
33308-3821
US

IV. Provider business mailing address

180 SYLVAN AVE SUITE 4
ENGLEWOOD CLIFFS NJ
07632-2519
US

V. Phone/Fax

Practice location:
  • Phone: 954-771-8400
  • Fax:
Mailing address:
  • Phone: 201-731-1700
  • 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: MARK FRIEDMAN
Title or Position: MANAGER
Credential:
Phone: 917-596-1800