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NPI Code Detail

MEDICARE: SOLARIS HEALTHCARE WINDERMERE LLC

MEDICARE: SOLARIS HEALTHCARE WINDERMERE 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 Facility

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 : 1912378514
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOLARIS HEALTHCARE WINDERMERE LLC
Provider Business Mailing Address
First Line : PO BOX 3310
Second Line :
City : WINDERMERE
State : FL
Zip : 34786-3310
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4875 CASON COVE DR
Second Line :
City : ORLANDO
State : FL
Zip : 32811-6302
Country : US
Telephone Number : 407-420-2090
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : BOBBY PATE
Credential :
Telephone Number : 407-420-2090
Provider Enumeration Date : 10/08/2015
Last Update Date : 12/11/2024

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Directions to “SOLARIS HEALTHCARE WINDERMERE LLC ” Practice Location

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