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NPI Code Detail

MEDICARE: PARADISE PINES HEALTH CARE ASSOCIATES LLC

MEDICARE: PARADISE PINES HEALTH CARE ASSOCIATES 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 FacilitySNF15640961FL

Other Identifiers

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

General Provider Information

NPI Number : 1467408054
Entity Type Code : Organization
Provider Name (Legal Business Name) : PARADISE PINES HEALTH CARE ASSOCIATES LLC
Provider Business Mailing Address
First Line : 11565 HARTS RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32218-3777
Country : US
Telephone Number : 904-751-1834
Fax Number : 904-751-0272
Provider Business Practice Location Address
First Line : 11565 HARTS RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32218-3777
Country : US
Telephone Number : 904-751-1834
Fax Number : 904-751-0272
Authorized Official
Title or Position : MANAGER
Name : NEIL RAMSKI
Credential :
Telephone Number : 904-751-1834
Provider Enumeration Date : 05/25/2006
Last Update Date : 11/21/2012

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