Healthcare Provider Details

I. General information

NPI: 1992771547
Provider Name (Legal Business Name): NEW PORT RICHEY SNF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6020 INDIANA AVE
NEW PORT RICHEY FL
34653-3214
US

IV. Provider business mailing address

7491 W OAKLAND PARK BLVD SUITE 100
TAMARAC FL
33319-4989
US

V. Phone/Fax

Practice location:
  • Phone: 727-843-0600
  • Fax:
Mailing address:
  • Phone: 954-358-1660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF1473096
License Number StateFL

VIII. Authorized Official

Name: RON OSTROFF
Title or Position: OWNER
Credential:
Phone: 954-358-1660