MEDICARE: LA MER NH II 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1171096	OTHER	FL	LICENSE NUMBER

General Provider Information

NPI Number	:	1366953887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LA MER NH II LLC

Provider Business Mailing Address
First Line	:	4042 PARK OAKS BLVD STE 300
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-9539
Country	:	US
Telephone Number	:	813-635-9500
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 9TH ST
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-5722
Country	:	US
Telephone Number	:	305-531-3321
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT AND CFO
Name	:	RONALD J SWARTZ
Credential	:
Telephone Number	:	813-635-9500

Provider Enumeration Date	:	10/24/2017
Last Update Date	:	10/24/2017

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Directions to “LA MER NH II LLC ” Practice Location

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