MEDICARE: HCP DELRAY BEACH FL OPCO 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	AL9881	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	:	1396232112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HCP DELRAY BEACH FL OPCO LLC

Provider Business Mailing Address
First Line	:	8020 W ATLANTIC AVE
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33446-9713
Country	:	US
Telephone Number	:	561-498-0134
Fax Number	:	561-498-3161

Provider Business Practice Location Address
First Line	:	8020 W ATLANTIC AVE
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33446-9713
Country	:	US
Telephone Number	:	561-498-0134
Fax Number	:	561-498-3161

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	PAUL MARKOWITZ
Credential	:
Telephone Number	:	561-498-0134

Provider Enumeration Date	:	04/17/2018
Last Update Date	:	04/17/2018

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