MEDICARE: FLORIDA MENTOR II 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	315P00000X	Intellectual Disabilities Intermediate Care Facility

Other Identifiers

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

General Provider Information

NPI Number	:	1780281824
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA MENTOR II LLC

Provider Business Mailing Address
First Line	:	3258 PARKSIDE CENTER CIR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-0907
Country	:	US
Telephone Number	:	813-389-8300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 VILLA DR
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32506-5535
Country	:	US
Telephone Number	:	850-453-2323
Fax Number	:	850-455-4203

Authorized Official
Title or Position	:	VICE PRESIDENT OF OPERATIONS
Name	:	CAROL SWANSON
Credential	:
Telephone Number	:	813-389-8300

Provider Enumeration Date	:	10/01/2020
Last Update Date	:	11/18/2020

Similar Medicare Providers

1841299450 — PENSACOLA DEVELOPMENTAL CENTER
Practice Location Address:

1 VILLA DR
PENSACOLA, FL
32506-5535

Practice Phone: 850-453-2323
Practice Fax:

1386648376 — DR. EDWIN P ROBERTS D.C.
Practice Location Address:

4469 MOBILE HWY STE D
PENSACOLA, FL
32506-7100

Practice Phone: 850-912-4155
Practice Fax:

1588668552 — THOMAS A ROBERTS D.C.
Practice Location Address:

730 N NEW WARRINGTON RD
PENSACOLA, FL
32506-4247

Practice Phone: 850-456-4788
Practice Fax:

1265425755 — JAMES WILLIAM ANDREWS OD
Practice Location Address:

5062 MOBILE HWY
PENSACOLA, FL
32506-3240

Practice Phone: 850-453-4373
Practice Fax: 850-453-1953

1023003589 — MR. CHRISTOPHER H RUSH MD
Practice Location Address:

321 S FAIRFIELD DR
PENSACOLA, FL
32506-4990

Practice Phone: 850-474-8546
Practice Fax: 850-456-7222

1013902857 — MR. DAVID R SMITH MD
Practice Location Address:

321 S FAIRFIELD DR
PENSACOLA, FL
32506-1412

Practice Phone: 850-458-4200
Practice Fax: 850-456-7222

Directions to “FLORIDA MENTOR II LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.