MEDICARE: PINECREST SNF OPERATIONS 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	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1760272389
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINECREST SNF OPERATIONS LLC

Provider Business Mailing Address
First Line	:	465 OBERLIN AVE S STE 401
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-6904
Country	:	US
Telephone Number	:	212-308-1600
Fax Number	:

Provider Business Practice Location Address
First Line	:	13650 NE 3RD CT
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-3626
Country	:	US
Telephone Number	:	305-893-1170
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SOLOMON KLEIN
Credential	:
Telephone Number	:	347-909-1811

Provider Enumeration Date	:	05/07/2025
Last Update Date	:	07/07/2025

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