Healthcare Provider Details

I. General information

NPI: 1295754315
Provider Name (Legal Business Name): HGRNC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8333 W OKEECHOBEE RD
HIALEAH GARDENS FL
33016-2109
US

IV. Provider business mailing address

2979 PGA BLVD.
PALM BEACH GARDENS FL
33410
US

V. Phone/Fax

Practice location:
  • Phone: 305-556-9900
  • Fax: 305-821-8027
Mailing address:
  • Phone: 561-627-0664
  • Fax: 561-627-2867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF1065096
License Number StateFL

VIII. Authorized Official

Name: MRS. JULIE C. KLEISER
Title or Position: AUDIT & REIMBURSEMENT SR. ANALYST
Credential:
Phone: 561-627-0664