Healthcare Provider Details

I. General information

NPI: 1457680100
Provider Name (Legal Business Name): CRADLING HANDS PEDIATRIC CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2009
Last Update Date: 12/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2319 SE 58TH AVENUE
OCALA FL
34480
US

IV. Provider business mailing address

14495 SE 80TH AVENUE
SUMMERFIELD FL
34491
US

V. Phone/Fax

Practice location:
  • Phone: 352-620-0700
  • Fax: 352-620-2136
Mailing address:
  • Phone: 352-670-0700
  • Fax: 352-620-2136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3140N1450X
TaxonomyPediatric Skilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. JOAN V. SUTHERLAND
Title or Position: PRESIDENT
Credential: RN
Phone: 352-620-0700