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General NPI Number Information
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NPI Number | 1134038433
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Entity Type | Organization
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Legal Business Name | SS POLK III COMMUNITY HC LLC
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Dates
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Enumeration Date | 09/02/2026
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Last Update Date | 09/02/2026
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Provider Practice Location Address
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Address Line | 610 E BELLA VISTA ST
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City | LAKELAND
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State | FL
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Zip | 33805-3008
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Country | US
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Telephone | 863-688-8591
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Fax |
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Provider Business Mailing Address
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Address Line | 610 E BELLA VISTA ST
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City | LAKELAND
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State | FL
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Zip | 33805-3008
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Country | US
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Telephone | 863-688-8591
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Fax |
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Authorized Official
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Title or Position | SENIOR LEGAL/RISK MANAGER
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Name | ALICIA CEPEDA
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Credential |
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Telephone | 385-342-5175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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