Healthcare Provider Details

I. General information

NPI: 1881521045
Provider Name (Legal Business Name): SUWANNEE FL OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 NW 15TH AVE
JASPER FL
32052
US

IV. Provider business mailing address

3512 QUENTIN RD STE 200
BROOKLYN NY
11234-4245
US

V. Phone/Fax

Practice location:
  • Phone: 386-792-1868
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ROBERT SCHOENFELD
Title or Position: AUTHORIZED SIGNER
Credential:
Phone: 917-699-3048