Healthcare Provider Details

I. General information

NPI: 1770734923
Provider Name (Legal Business Name): OSCEOLA NURSING AND REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2008
Last Update Date: 10/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 W NEW NOLTE RD
SAINT CLOUD FL
34772-7100
US

IV. Provider business mailing address

4201 W NEW NOLTE RD
SAINT CLOUD FL
34772-7100
US

V. Phone/Fax

Practice location:
  • Phone: 407-957-3341
  • Fax:
Mailing address:
  • Phone: 407-957-3341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: SHELBY PARKER
Title or Position: DIRECTOR
Credential:
Phone: 407-420-2090