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NPI Code Detail

MEDICARE: EMERALD COAST REHABILITATION CENTER, LLC

MEDICARE: EMERALD COAST REHABILITATION 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 FacilitySNF11410961FL

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 : 1891799623
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMERALD COAST REHABILITATION CENTER, LLC
Provider Business Mailing Address
First Line : 1665 PALM BEACH LAKES BLVD STE 400
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33401-2108
Country : US
Telephone Number : 561-223-4300
Fax Number :
Provider Business Practice Location Address
First Line : 114 3RD ST SE
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32548-5401
Country : US
Telephone Number : 850-243-6134
Fax Number : 850-243-9759
Authorized Official
Title or Position : PRESIDENT
Name : HOWARD JAFFE
Credential :
Telephone Number : 215-346-6454
Provider Enumeration Date : 06/09/2005
Last Update Date : 03/17/2025

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