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NPI Code Detail

MEDICARE: JACKSONVILLE FL OPCO LLC

MEDICARE: JACKSONVILLE 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
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1538745864
Entity Type Code : Organization
Provider Name (Legal Business Name) : JACKSONVILLE FL OPCO LLC
Provider Business Mailing Address
First Line : 8495 NORMANDY BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32221-6701
Country : US
Telephone Number : 904-783-3749
Fax Number :
Provider Business Practice Location Address
First Line : 8495 NORMANDY BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32221-6701
Country : US
Telephone Number : 904-783-3749
Fax Number :
Authorized Official
Title or Position : CEO, EMPIRE CARE CENTERS
Name : SHLOMO E HELLER
Credential :
Telephone Number : 470-737-0111
Provider Enumeration Date : 03/18/2021
Last Update Date : 03/18/2021

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Directions to “JACKSONVILLE FL OPCO LLC ” Practice Location

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