Healthcare Provider Details

I. General information

NPI: 1538858030
Provider Name (Legal Business Name): BROOKDALE MANAGEMENT OF FLORIDA PO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2023
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8015 PIN OAK DR
ORLANDO FL
32819-7108
US

IV. Provider business mailing address

8015 PIN OAK DR
ORLANDO FL
32819-7108
US

V. Phone/Fax

Practice location:
  • Phone: 407-363-4511
  • Fax:
Mailing address:
  • Phone: 407-363-4511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: ANNA F.C. MUNOZ
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 414-918-5443