Healthcare Provider Details

I. General information

NPI: 1982838330
Provider Name (Legal Business Name): KEY WEST HEALTH AND REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2009
Last Update Date: 07/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5860 W JUNIOR COLLEGE RD
KEY WEST FL
33040-4314
US

IV. Provider business mailing address

1240 MARBELLA PLAZA DR
TAMPA FL
33619-7906
US

V. Phone/Fax

Practice location:
  • Phone: 813-341-2700
  • Fax: 813-676-0126
Mailing address:
  • Phone: 813-341-2700
  • Fax: 813-676-0126

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: MR. ROBERT DANIEL VAUGHAN
Title or Position: PRESIDENT
Credential:
Phone: 813-341-2700