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General NPI Number Information
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NPI Number | 1679123822
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Entity Type | Organization
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Legal Business Name | FLORENCE PARK LLC
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Dates
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Enumeration Date | 09/18/2019
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Last Update Date | 09/18/2019
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Provider Practice Location Address
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Address Line | 815 W DAUGHTERY RD
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City | LAKELAND
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State | FL
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Zip | 33809-3121
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Country | US
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Telephone | 863-859-0475
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Fax |
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Provider Business Mailing Address
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Address Line | 1435 E 22ND ST
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City | BROOKLYN
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State | NY
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Zip | 11210-5110
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Country | US
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Telephone | 917-538-5737
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | SOL GREENSTEIN
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Credential |
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Telephone | 718-256-1906
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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