MEDICARE: SKYCREST PLACE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1194463000
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKYCREST PLACE LLC

Provider Business Mailing Address
First Line	:	106 OAK AVE
Second Line	:
City	:	SAFETY HARBOR
State	:	FL
Zip	:	34695-3708
Country	:	US
Telephone Number	:	727-254-1196
Fax Number	:

Provider Business Practice Location Address
First Line	:	1960 CLEVELAND ST
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33765-3016
Country	:	US
Telephone Number	:	727-254-1196
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	STEPHEN WEIK
Credential	:
Telephone Number	:	727-254-1196

Provider Enumeration Date	:	05/22/2022
Last Update Date	:	05/22/2022

Similar Medicare Providers

1760423446 — DR. DEBRA A THOMAS-WEIBLE M.D.
Practice Location Address:

1006 N FORT HARRISON AVE
CLEARWATER, FL
33755-3016

Practice Phone: 727-446-6719
Practice Fax: 727-461-1397

1073472098 — JORDAN EVANS
Practice Location Address:

50 S BELCHER RD
CLEARWATER, FL
33765-3938

Practice Phone: 877-823-4283
Practice Fax:

1215247747 — COMPREHENSIVE SPINE INSTITUTE, LLC
Practice Location Address:

1988 GULF TO BAY BLVD
CLEARWATER, FL
33765-3550

Practice Phone: 727-953-8090
Practice Fax: 727-953-8088

1336645464 — RICHARD A WOLF II MSN, FNP-C
Practice Location Address:

2370 DREW ST STE B
CLEARWATER, FL
33765-3318

Practice Phone: 727-461-1543
Practice Fax:

1558916494 — BENJAMIN DEVRIES DO LLC
Practice Location Address:

1831 N BELCHER RD STE A3
CLEARWATER, FL
33765-1417

Practice Phone: 727-600-8500
Practice Fax: 877-692-1943

1164738159 — DR. BENJAMIN DEVRIES DO
Practice Location Address:

1831 N BELCHER RD STE A3
CLEARWATER, FL
33765-1417

Practice Phone: 727-600-8500
Practice Fax: 877-692-1943

Directions to “SKYCREST PLACE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.