MEDICARE: SAINTS 120 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	1007096	FL

General Provider Information

NPI Number	:	1417351768
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAINTS 120 LLC

Provider Business Mailing Address
First Line	:	4700 SHERIDAN ST
Second Line	:	STE 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	:	5888 BLANDING BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-1927
Country	:	US
Telephone Number	:	904-772-1220
Fax Number	:	904-772-6334

Authorized Official
Title or Position	:	CFO
Name	:	MARGARET H FERNANDEZ
Credential	:
Telephone Number	:	954-367-4563

Provider Enumeration Date	:	10/15/2014
Last Update Date	:	10/15/2014

Similar Medicare Providers

1942298849 — ALL SAINTS NURSING HOME & REHAB. CENTER, INC.
Practice Location Address:

5888 BLANDING BLVD
JACKSONVILLE, FL
32244-1927

Practice Phone: 904-772-1220
Practice Fax: 904-772-6334

1922581925 — 5888 GOLDEN LLC
Practice Location Address:

5888 BLANDING BLVD
JACKSONVILLE, FL
32244-1927

Practice Phone: 954-367-4597
Practice Fax: 954-367-4564

1437760121 — CENTER FOR AGING AND REHABILITATION OF JACKSONVILLE INC
Practice Location Address:

5888 BLANDING BLVD
JACKSONVILLE, FL
32244-1927

Practice Phone: 904-772-1220
Practice Fax: 904-772-6334

1609652478 — JACKSONVILLE OPCO LLC
Practice Location Address:

5888 BLANDING BLVD
JACKSONVILLE, FL
32244-1927

Practice Phone: 718-916-1443
Practice Fax:

1144410515 — THAO PHUONG HOANG M.A., CCC/SLP
Practice Location Address:

1347 N KYLE WAY
JACKSONVILLE, FL
32259-1927

Practice Phone: 904-631-0885
Practice Fax:

1265777650 — MS. ERICA NICOLE MASON R.D.
Practice Location Address:

8610 BRAZIL RD
JACKSONVILLE, FL
32208-1927

Practice Phone: 904-703-4711
Practice Fax:

Directions to “SAINTS 120 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.