MEDICARE: MFP 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
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1609634195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MFP OPCO LLC

Provider Business Mailing Address
First Line	:	4201 S 25TH ST
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34981-5004
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4201 S 25TH ST
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34981-5004
Country	:	US
Telephone Number	:	772-444-6406
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	TIFFANY RINK
Credential	:
Telephone Number	:	772-444-6406

Provider Enumeration Date	:	03/08/2024
Last Update Date	:	03/08/2024

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Directions to “MFP OPCO LLC ” Practice Location

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