Provider Demographics
NPI:1376580712
Name:PLANTATION KEY CONVALESCENT CENTER INC
Entity Type:Organization
Organization Name:PLANTATION KEY CONVALESCENT CENTER INC
Other - Org Name:COMPREHENSIVE CARE CENTER OF PLANTATION KEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:BECHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-374-9144
Mailing Address - Street 1:48 HIGH POINT ROAD
Mailing Address - Street 2:
Mailing Address - City:TAVERNIER
Mailing Address - State:FL
Mailing Address - Zip Code:33070
Mailing Address - Country:US
Mailing Address - Phone:305-852-3021
Mailing Address - Fax:305-258-3721
Practice Address - Street 1:48 HIGH POINT ROAD
Practice Address - Street 2:
Practice Address - City:TAVERNIER
Practice Address - State:FL
Practice Address - Zip Code:33070
Practice Address - Country:US
Practice Address - Phone:305-852-3021
Practice Address - Fax:305-258-3721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF1446096314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020890600Medicaid
FL020890600Medicaid