Healthcare Provider Details

I. General information

NPI: 1962455774
Provider Name (Legal Business Name): TAMARAC REHABILITATION & HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 09/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 NW 88TH AVE
TAMARAC FL
33321-2003
US

IV. Provider business mailing address

7901 NW 88TH AVE
TAMARAC FL
33321-2003
US

V. Phone/Fax

Practice location:
  • Phone: 954-722-9330
  • Fax: 954-720-0020
Mailing address:
  • Phone: 954-722-9330
  • Fax: 954-720-0020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF15490961
License Number StateFL

VIII. Authorized Official

Name: NEIL SUTTON
Title or Position: NURSING HOME ADMINISTRATOR
Credential: N.H.A.
Phone: 954-722-9330