Healthcare Provider Details

I. General information

NPI: 1326267519
Provider Name (Legal Business Name): SOUTH CENTRAL NURSING HOMES OF ZEPHYRHILLS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 10/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38250 A AVE
ZEPHYRHILLS FL
33542-5759
US

IV. Provider business mailing address

602 COURTLAND ST SUITE 200
ORLANDO FL
32804-1360
US

V. Phone/Fax

Practice location:
  • Phone: 813-782-5508
  • Fax: 813-783-1586
Mailing address:
  • Phone: 407-975-3000
  • Fax: 407-975-3090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF16150961
License Number StateFL

VIII. Authorized Official

Name: MR. DAVID RODMAN
Title or Position: ASST. SECRETARY
Credential:
Phone: 407-975-3011