Provider Demographics
NPI:1134278203
Name:OSPREY OF NORTH FLORIDA, INC.
Entity Type:Organization
Organization Name:OSPREY OF NORTH FLORIDA, INC.
Other - Org Name:BAYA POINTE NURSING & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:GNEWUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-752-7800
Mailing Address - Street 1:587 SE ERMINE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-6126
Mailing Address - Country:US
Mailing Address - Phone:386-752-7800
Mailing Address - Fax:386-752-7337
Practice Address - Street 1:587 SE ERMINE AVE
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-6126
Practice Address - Country:US
Practice Address - Phone:386-752-7800
Practice Address - Fax:386-752-7337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF12700961314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105846Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER