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NPI Code Detail

MEDICARE: FT PIERCE OPCO LLC

MEDICARE: FT PIERCE 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 : 1588341382
Entity Type Code : Organization
Provider Name (Legal Business Name) : FT PIERCE OPCO LLC
Provider Business Mailing Address
First Line : 700 S 29TH ST
Second Line :
City : FORT PIERCE
State : FL
Zip : 34947-3626
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 700 S 29TH ST
Second Line :
City : FORT PIERCE
State : FL
Zip : 34947-3626
Country : US
Telephone Number : 772-465-7560
Fax Number :
Authorized Official
Title or Position : MEMBER
Name : JOSEF CUKIER
Credential :
Telephone Number : 732-200-1155
Provider Enumeration Date : 07/03/2023
Last Update Date : 07/03/2023

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Directions to “FT PIERCE OPCO LLC ” Practice Location

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