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NPI Code Detail

MEDICARE: SENIOR CARE GROUP

MEDICARE: SENIOR CARE GROUP
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 Facility1282096FL

General Provider Information

NPI Number : 1821006701
Entity Type Code : Organization
Provider Name (Legal Business Name) : SENIOR CARE GROUP
Provider Business Mailing Address
First Line : 16002 LAKESHORE VILLA DR
Second Line :
City : TAMPA
State : FL
Zip : 33613-1367
Country : US
Telephone Number : 813-968-5093
Fax Number : 813-264-0476
Provider Business Practice Location Address
First Line : 16002 LAKESHORE VILLA DR
Second Line :
City : TAMPA
State : FL
Zip : 33613-1367
Country : US
Telephone Number : 813-968-5093
Fax Number : 813-264-0476
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. RONALD MILLINER
Credential :
Telephone Number : 813-968-5093
Provider Enumeration Date : 08/04/2006
Last Update Date : 08/22/2020

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1184943888 — REBECCA L MARTINEZ-MURRAY
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Directions to “SENIOR CARE GROUP ” Practice Location

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