Provider Demographics
NPI:1457680100
Name:CRADLING HANDS PEDIATRIC CARE CORP
Entity Type:Organization
Organization Name:CRADLING HANDS PEDIATRIC CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:V
Authorized Official - Last Name:SUTHERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:352-620-0700
Mailing Address - Street 1:14495 SE 80TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491
Mailing Address - Country:US
Mailing Address - Phone:352-670-0700
Mailing Address - Fax:352-620-2136
Practice Address - Street 1:2319 SE 58TH AVENUE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34480
Practice Address - Country:US
Practice Address - Phone:352-620-0700
Practice Address - Fax:352-620-2136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL60080991OtherCERTIFICATE #345