Healthcare Provider Details

I. General information

NPI: 1811488562
Provider Name (Legal Business Name): HEALTH CARE AND RETIREMENT CORPORATION OF AMERICA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2018
Last Update Date: 05/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5511 SWIFT RD
SARASOTA FL
34231-6209
US

IV. Provider business mailing address

333 N SUMMIT ST FL 7
TOLEDO OH
43604-1531
US

V. Phone/Fax

Practice location:
  • Phone: 800-427-1902
  • Fax: 419-531-2664
Mailing address:
  • Phone: 800-427-1902
  • Fax: 419-531-2664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: MARTIN DAVID ALLEN
Title or Position: DIRECTOR
Credential:
Phone: 419-252-5734