Healthcare Provider Details

I. General information

NPI: 1942412614
Provider Name (Legal Business Name): FLORIDA PREFERRED CARE HEALTH FACILITIES III, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 06/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 54TH ST
WEST PALM BEACH FL
33407-2419
US

IV. Provider business mailing address

5420 W PLANO PKWY
PLANO TX
75093-4823
US

V. Phone/Fax

Practice location:
  • Phone: 305-992-7765
  • Fax: 305-868-2304
Mailing address:
  • Phone: 972-931-3800
  • Fax: 972-767-6222

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: MRS. JAMIE LATTURE COLLIER
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 972-931-3800