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NPI Code Detail

MEDICARE: BALMORAL TENANT SERVICES, INC.

MEDICARE: BALMORAL TENANT SERVICES, 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
1310400000XAssisted Living FacilityAL8728FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710308093
Entity Type Code : Organization
Provider Name (Legal Business Name) : BALMORAL TENANT SERVICES, INC.
Provider Business Mailing Address
First Line : 1440 HIGHWAY A1A
Second Line :
City : VERO BEACH
State : FL
Zip : 32963-2310
Country : US
Telephone Number : 772-492-5002
Fax Number : 772-492-5005
Provider Business Practice Location Address
First Line : 2960 TAMPA RD
Second Line :
City : PALM HARBOR
State : FL
Zip : 34684-3340
Country : US
Telephone Number : 727-781-8686
Fax Number : 727-784-7200
Authorized Official
Title or Position : TREASURER
Name : THOMAS MITCHELL
Credential :
Telephone Number : 772-492-5002
Provider Enumeration Date : 01/03/2014
Last Update Date : 01/03/2014

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Directions to “BALMORAL TENANT SERVICES, INC. ” Practice Location

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