MEDICARE: PALM GARDEN OF PINELLAS 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	314000000X	Skilled Nursing Facility	1418095	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316372360
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALM GARDEN OF PINELLAS LLC

Provider Business Mailing Address
First Line	:	2033 MAIN ST
Second Line	:	SUITE 302
City	:	SARASOTA
State	:	FL
Zip	:	34237-6056
Country	:	US
Telephone Number	:	941-952-9411
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 16TH AVE SE
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33771-4400
Country	:	US
Telephone Number	:	941-952-9411
Fax Number	:	941-952-9331

Authorized Official
Title or Position	:	AUTHORIZED REPRESENTATIVE
Name	:	MORRIS H. MILLER
Credential	:
Telephone Number	:	941-952-9411

Provider Enumeration Date	:	09/10/2013
Last Update Date	:	12/04/2013

Similar Medicare Providers

1013913235 — SA-PG PINELLAS, LLC
Practice Location Address:

200 16TH AVE SE
LARGO, FL
33771-4400

Practice Phone: 727-585-9377
Practice Fax: 727-588-9038

1740775972 — BRITTA ANNE CASTALINE LPN
Practice Location Address:

200 16TH AVE SE
LARGO, FL
33771-4400

Practice Phone: 727-585-9377
Practice Fax:

1619923158 — BAY CENTER FOR PAIN MANAGEMENT PA
Practice Location Address:

1715 E BAY DR STE A
LARGO, FL
33771-2279

Practice Phone: 727-588-0366
Practice Fax: 727-588-0370

1922003425 — MRS. NADINE MARIE VERDEBOUT P.T., M.L.T.
Practice Location Address:

2480 E BAY DR , STE B13
LARGO, FL
33771-2441

Practice Phone: 727-535-6746
Practice Fax: 727-536-6006

1538166608 — DR. TIMOTHY JOSEPH VAUGHAN M.D.
Practice Location Address:

1725 E BAY DR , SUITE A
LARGO, FL
33771-2208

Practice Phone: 727-584-9810
Practice Fax: 727-584-9812

1255338083 — DR. MARY J KING DO
Practice Location Address:

10225 ULMERTON RD STE 1A
LARGO, FL
33771-3522

Practice Phone: 727-585-7408
Practice Fax: 866-980-2443

Directions to “PALM GARDEN OF PINELLAS 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.