Provider Demographics
NPI:1477078574
Name:SONATA COCONUT CREEK, LLC
Entity Type:Organization
Organization Name:SONATA COCONUT CREEK, LLC
Other - Org Name:HCP COCONUT CREEK FL OPCO, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS OFFICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARONSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-975-6399
Mailing Address - Street 1:4175 W SAMPLE RD
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4456
Mailing Address - Country:US
Mailing Address - Phone:954-975-6399
Mailing Address - Fax:954-975-9538
Practice Address - Street 1:4175 W SAMPLE RD
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4456
Practice Address - Country:US
Practice Address - Phone:954-975-6399
Practice Address - Fax:954-975-9538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL9784310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020655700Medicaid