Provider Demographics
NPI:1518210715
Name:PINNACLE HEALTHCARE SERVICES INC.
Entity Type:Organization
Organization Name:PINNACLE HEALTHCARE SERVICES INC.
Other - Org Name:HEART OF FLORIDA ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-787-1260
Mailing Address - Street 1:1694 BAYHILL DR
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-1956
Mailing Address - Country:US
Mailing Address - Phone:727-787-1260
Mailing Address - Fax:727-787-1260
Practice Address - Street 1:301 S 10TH ST
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-5601
Practice Address - Country:US
Practice Address - Phone:863-421-9581
Practice Address - Fax:863-422-9581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility