Healthcare Provider Details

I. General information

NPI: 1184585002
Provider Name (Legal Business Name): VENICE SNF OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 ALBEE FARM RD
VENICE FL
34285-6213
US

IV. Provider business mailing address

8123 NW 161ST TER
MIAMI LAKES FL
33016-6659
US

V. Phone/Fax

Practice location:
  • Phone: 732-592-2205
  • 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: BEREL FOLLMAN
Title or Position: MANAGER
Credential:
Phone: 732-592-2205