| NPI | 1538254222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE LYNN CAVAIUOLO Member Billing Coordinator 352-548-1016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: FL SNF130471032) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |