Healthcare Provider Details

I. General information

NPI: 1104849066
Provider Name (Legal Business Name): SARASOTA FACILITY OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 12/22/2021
Certification Date: 12/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4783 FRUITVILLE RD
SARASOTA FL
34232-1815
US

IV. Provider business mailing address

4783 FRUITVILLE RD
SARASOTA FL
34232-1815
US

V. Phone/Fax

Practice location:
  • Phone: 941-378-8000
  • Fax: 941-377-1454
Mailing address:
  • Phone: 941-378-8000
  • Fax: 941-377-1454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF130470982
License Number StateFL

VIII. Authorized Official

Name: KENNETH USSERY
Title or Position: VP
Credential:
Phone: 407-571-1550