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NPI 1508860115

NPI 1508860115 : FI-TITUSVILLE, LLC : TITUSVILLE, FL

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General NPI Number Information
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    NPI Number           |    1508860115
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    Entity Type          |    Organization 
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    Legal Business Name  |    FI-TITUSVILLE, 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         |    1705 JESS PARRISH CT 
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    City                 |    TITUSVILLE
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    State                |    FL
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    Zip                  |    32796-2158
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    Country              |    US
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    Telephone            |    321-269-5720
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    Fax                  |    321-269-6245
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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                  |    
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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       |    SNF1561096
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    License Number State |    FL
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