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NPI Code Detail

MEDICARE: 4445 MANAGEMENT LLC

MEDICARE: 4445 MANAGEMENT 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
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1316954720
Entity Type Code : Organization
Provider Name (Legal Business Name) : 4445 MANAGEMENT LLC
Provider Business Mailing Address
First Line : 4700 SHERIDAN ST
Second Line : SUITE B
City : HOLLYWOOD
State : FL
Zip : 33021-3420
Country : US
Telephone Number : 954-367-4563
Fax Number : 954-367-4564
Provider Business Practice Location Address
First Line : 4445 PINE FOREST DR
Second Line :
City : LAKE WORTH
State : FL
Zip : 33463-4676
Country : US
Telephone Number : 561-965-5954
Fax Number : 561-433-9161
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : MS. MARGARET H FERNANDEZ
Credential :
Telephone Number : 954-367-4563
Provider Enumeration Date : 08/01/2006
Last Update Date : 11/10/2008

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