Healthcare Provider Details

I. General information

NPI: 1720081011
Provider Name (Legal Business Name): FLORIDA LIVING OPTIONS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 08/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 SW 33RD AVE
OCALA FL
34474-4466
US

IV. Provider business mailing address

4100 SW 33RD AVE
OCALA FL
34474-4466
US

V. Phone/Fax

Practice location:
  • Phone: 352-237-7776
  • Fax: 352-237-5551
Mailing address:
  • Phone: 352-237-7776
  • Fax: 352-237-5551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF1541096
License Number StateFL

VIII. Authorized Official

Name: MR. RONALD J WILSON
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 309-343-1550