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General NPI Number Information
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NPI Number | 1497093207
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Entity Type | Organization
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Legal Business Name | FLORIDA LIVING OPTIONS INC
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Dates
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Enumeration Date | 01/29/2013
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Last Update Date | 01/29/2013
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Provider Practice Location Address
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Address Line | 5381 DESOTO RD
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City | SARASOTA
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State | FL
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Zip | 34235-2618
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Country | US
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Telephone | 941-355-6111
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Fax |
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Provider Business Mailing Address
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Address Line | 5381 DESOTO RD
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City | SARASOTA
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State | FL
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Zip | 34235-2618
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Country | US
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Telephone | 941-355-6111
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MR. RONALD J WILSON
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Credential |
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Telephone | 309-343-1550
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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 | SNF130471051
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License Number State | FL
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