Healthcare Provider Details

I. General information

NPI: 1497093207
Provider Name (Legal Business Name): FLORIDA LIVING OPTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2013
Last Update Date: 01/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5381 DESOTO RD
SARASOTA FL
34235-2618
US

IV. Provider business mailing address

5381 DESOTO RD
SARASOTA FL
34235-2618
US

V. Phone/Fax

Practice location:
  • Phone: 941-355-6111
  • Fax:
Mailing address:
  • Phone: 941-355-6111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF130471051
License Number StateFL

VIII. Authorized Official

Name: MR. RONALD J WILSON
Title or Position: CFO
Credential:
Phone: 309-343-1550