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NPI Code Detail

MEDICARE: BRIDGEVIEW CENTER, LLC

MEDICARE: BRIDGEVIEW CENTER, 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
1314000000XSkilled Nursing FacilitySNF10590961FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1N98OTHERFLBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
30007930518OTHERFLAETNA
4C105402OTHERFLUNITED AMERICAN
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821086091
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIDGEVIEW CENTER, LLC
Provider Business Mailing Address
First Line : 350 S RIDGEWOOD AVE
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-7028
Country : US
Telephone Number : 386-677-4545
Fax Number : 386-677-3445
Provider Business Practice Location Address
First Line : 350 S RIDGEWOOD AVE
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-7028
Country : US
Telephone Number : 386-677-4545
Fax Number : 386-677-3445
Authorized Official
Title or Position : VP FINANCE
Name : MRS. JENNIFER ALISE ZIOLKOWSKI
Credential : MBA
Telephone Number : 813-558-6629
Provider Enumeration Date : 10/11/2005
Last Update Date : 06/12/2024

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Directions to “BRIDGEVIEW CENTER, LLC ” Practice Location

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