Healthcare Provider Details

I. General information

NPI: 1881189884
Provider Name (Legal Business Name): PARKVIEW REHABILITATION CENTER AT WINTER PARK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2018
Last Update Date: 06/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2075 LOCH LOMOND DR
WINTER PARK FL
32792-4183
US

IV. Provider business mailing address

101 SUNNYTOWN RD STE 201
CASSELBERRY FL
32707-3862
US

V. Phone/Fax

Practice location:
  • Phone: 407-628-5418
  • Fax:
Mailing address:
  • Phone: 407-830-5309
  • Fax: 407-830-7775

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: MR. DON MELTON
Title or Position: CFO
Credential:
Phone: 407-830-5309