Healthcare Provider Details

I. General information

NPI: 1720765522
Provider Name (Legal Business Name): SEBRING OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 07/03/2023
Certification Date: 07/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3011 KENILWORTH BLVD
SEBRING FL
33870-4310
US

IV. Provider business mailing address

3011 KENILWORTH BLVD
SEBRING FL
33870-4310
US

V. Phone/Fax

Practice location:
  • Phone: 863-382-2153
  • Fax:
Mailing address:
  • Phone:
  • 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: JOSEF CUKIER
Title or Position: MEMBER
Credential:
Phone: 732-200-1155