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NPI Code Detail

MEDICARE: BRISTOL AT TAMPA REHABILITATION AND NURSING CENTER LLC

MEDICARE: BRISTOL AT TAMPA REHABILITATION AND NURSING CENTER 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
1313M00000XNursing Facility/Intermediate Care Facility

General Provider Information

NPI Number : 1578000709
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRISTOL AT TAMPA REHABILITATION AND NURSING CENTER LLC
Provider Business Mailing Address
First Line : 180 SYLVAN AVE
Second Line :
City : ENGLEWOOD CLIFFS
State : NJ
Zip : 07632-2512
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1818 E FLETCHER AVE
Second Line :
City : TAMPA
State : FL
Zip : 33612-3770
Country : US
Telephone Number : 201-731-1700
Fax Number :
Authorized Official
Title or Position : PARTNER
Name : MARK FRIEDMAN
Credential :
Telephone Number : 201-731-1700
Provider Enumeration Date : 01/26/2017
Last Update Date : 01/26/2017

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