Healthcare Provider Details

I. General information

NPI: 1518907039
Provider Name (Legal Business Name): TANDEM HEALTH CARE OF LAKELAND, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5245 N SOCRUM LOOP RD
LAKELAND FL
33809-4253
US

IV. Provider business mailing address

800 CONCOURSE PKWY S SUITE 200
MAITLAND FL
32751-6148
US

V. Phone/Fax

Practice location:
  • Phone: 863-859-1446
  • Fax: 863-859-4307
Mailing address:
  • Phone: 407-571-1550
  • Fax: 407-571-1599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF1245095
License Number StateFL

VIII. Authorized Official

Name: MR. JOSEPH D. CONTE
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 407-571-1550