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General NPI Number Information
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NPI Number | 1295739803
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Entity Type | Organization
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Legal Business Name | FI-WALDEMERE, LLC
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Dates
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Enumeration Date | 06/10/2005
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 1524 S EAST AVE
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City | SARASOTA
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State | FL
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Zip | 34239-2324
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Country | US
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Telephone | 941-365-2422
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Fax | 941-952-1756
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Provider Business Mailing Address
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Address Line | 1665 PALM BEACH LAKES BLVD STE 400
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-2108
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Country | US
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Telephone | 561-801-7600
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Fax | 414-268-4811
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Authorized Official
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Title or Position | PRESIDENT
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Name | HOWARD JAFFE
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Credential |
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Telephone | 215-346-6454
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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 | SNF11350961
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License Number State | FL
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