Healthcare Provider Details

I. General information

NPI: 1134958499
Provider Name (Legal Business Name): WINTER PARK CARE AND REHAB OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2790 SCARLET RD
WINTER PARK FL
32792
US

IV. Provider business mailing address

2790 SCARLET RD
WINTER PARK FL
32792
US

V. Phone/Fax

Practice location:
  • Phone: 407-671-8030
  • Fax:
Mailing address:
  • Phone: 407-671-8030
  • 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: GEORGE HANLEY
Title or Position: NHA
Credential:
Phone: 407-671-8030