Healthcare Provider Details

I. General information

NPI: 1992572614
Provider Name (Legal Business Name): THE VILLAGES NURSING AND REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 HIGHWAY 466
LADY LAKE FL
32159-3926
US

IV. Provider business mailing address

700 N PALMETTO ST
LEESBURG FL
34748-4419
US

V. Phone/Fax

Practice location:
  • Phone: 352-430-0017
  • Fax:
Mailing address:
  • Phone: 954-774-7412
  • 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: ROBERT MANELA
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 954-774-7412