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General NPI Number Information
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NPI Number | 1518907039
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Entity Type | Organization
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Legal Business Name | TANDEM HEALTH CARE OF LAKELAND, INC.
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5245 N SOCRUM LOOP RD
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City | LAKELAND
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State | FL
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Zip | 33809-4253
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Country | US
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Telephone | 863-859-1446
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Fax | 863-859-4307
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Provider Business Mailing Address
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Address Line | 800 CONCOURSE PKWY S SUITE 200
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City | MAITLAND
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State | FL
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Zip | 32751-6148
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Country | US
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Telephone | 407-571-1550
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Fax | 407-571-1599
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MR. JOSEPH D. CONTE
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Credential |
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Telephone | 407-571-1550
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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 | SNF1245095
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License Number State | FL
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