Provider Demographics
NPI:1568832392
Name:AUBURNDALE OAKS CARE AND REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:AUBURNDALE OAKS CARE AND REHABILITATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-692-0600
Mailing Address - Street 1:919 OLD WINTER HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33823-4329
Mailing Address - Country:US
Mailing Address - Phone:863-967-4125
Mailing Address - Fax:
Practice Address - Street 1:919 OLD WINTER HAVEN RD
Practice Address - Street 2:
Practice Address - City:AUBURNDALE
Practice Address - State:FL
Practice Address - Zip Code:33823-4329
Practice Address - Country:US
Practice Address - Phone:863-967-4125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-06
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015959300Medicaid
FL105302Medicare Oscar/Certification