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General NPI Number Information
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NPI Number | 1427763853
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Entity Type | Organization
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Legal Business Name | WOODSIDE OPERATIONS, LLC
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Dates
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Enumeration Date | 01/19/2023
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Last Update Date | 01/19/2023
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Provider Practice Location Address
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Address Line | 3601 LAKEWOOD BLVD
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City | NAPLES
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State | FL
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Zip | 34112-6145
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Country | US
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Telephone | 239-775-7757
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Fax |
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Provider Business Mailing Address
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Address Line | 10150 HIGHLAND MANOR DR STE 300
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City | TAMPA
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State | FL
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Zip | 33610-9712
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | TRICIA THACKER
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Credential |
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Telephone | 813-558-6608
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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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