MEDICARE: BRANDYWINE CONVALESCENT CENTER INC

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	SNF10600961	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	:	1518941582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRANDYWINE CONVALESCENT CENTER INC

Provider Business Mailing Address
First Line	:	1801 LAKE MARIAM DR
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33884-0927
Country	:	US
Telephone Number	:	863-293-1989
Fax Number	:	863-299-6427

Provider Business Practice Location Address
First Line	:	1801 LAKE MARIAM DR
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33884-0927
Country	:	US
Telephone Number	:	863-293-1989
Fax Number	:	863-299-6427

Authorized Official
Title or Position	:	DIRECTOR OF ACCOUNTING
Name	:	VICTORIA LYNN SHARPLESS
Credential	:
Telephone Number	:	352-874-6007

Provider Enumeration Date	:	12/02/2005
Last Update Date	:	10/08/2020

Similar Medicare Providers

1477060754 — BRANDYWYNE ASSISTED LIVING FACILITY, LLC.
Practice Location Address:

1801 LAKE MARIAM DR
WINTER HAVEN, FL
33884-0927

Practice Phone: 813-293-9981
Practice Fax:

1154998995 — WINTER HAVEN NURSING LLC
Practice Location Address:

1801 LAKE MARIAM DR
WINTER HAVEN, FL
33884-0927

Practice Phone: 863-293-1989
Practice Fax: 863-299-6427

1114621851 — LAKE MARIAM FL OPCO LLC
Practice Location Address:

1801 LAKE MARIAM DR
WINTER HAVEN, FL
33884-0927

Practice Phone: 863-293-1989
Practice Fax:

1144228032 — VICKI C MOORE-MORBY APRN
Practice Location Address:

3000 WOODMONT AVE
WINTER HAVEN, FL
33884-3800

Practice Phone: 863-293-1191
Practice Fax:

1023965878 — BLUE DREAMS THERAPY CENTER INC
Practice Location Address:

3601 CYPRESS GARDENS RD
WINTER HAVEN, FL
33884-2487

Practice Phone: 786-631-3136
Practice Fax: 786-417-2606

1386590776 — BYRD SCREENING LLC
Practice Location Address:

552 CODY CALEB DR
WINTER HAVEN, FL
33884-2206

Practice Phone: 863-362-1795
Practice Fax:

Directions to “BRANDYWINE CONVALESCENT CENTER INC ” 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.