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General NPI Number Information
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NPI Number | 1588660922
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Entity Type | Organization
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Legal Business Name | ROYAL OAK NURSING CENTER, LLC
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 04/04/2012
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Provider Practice Location Address
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Address Line | 37300 ROYAL OAK LN
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City | DADE CITY
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State | FL
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Zip | 33525-5230
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Country | US
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Telephone | 352-567-3122
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Fax | 352-567-2250
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Provider Business Mailing Address
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Address Line | 37300 ROYAL OAK LN
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City | DADE CITY
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State | FL
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Zip | 33525-5230
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Country | US
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Telephone | 352-567-3122
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Fax | 352-567-2250
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. ANITA E HOWARD
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Credential |
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Telephone | 352-567-3122
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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 | SNF14840962
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License Number State | FL
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