Provider Demographics
NPI:1083660542
Name:DOLPHINS VIEW HEALTH CARE ASSOCIATES LLC
Entity Type:Organization
Organization Name:DOLPHINS VIEW HEALTH CARE ASSOCIATES LLC
Other - Org Name:HEALTH AND REHABILITATION CENTRE AT DOLPHINS VIEW, THE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:T
Authorized Official - Last Name:STRUNK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-384-9300
Mailing Address - Street 1:1820 SHORE DR S
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:FL
Mailing Address - Zip Code:33707-4601
Mailing Address - Country:US
Mailing Address - Phone:727-384-9300
Mailing Address - Fax:727-343-8430
Practice Address - Street 1:1820 SHORE DR S
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-4601
Practice Address - Country:US
Practice Address - Phone:727-384-9300
Practice Address - Fax:727-343-8430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF11260961314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL032052800Medicaid
105012Medicare Oscar/Certification