Provider Demographics
NPI:1578547535
Name:ORLANDO MANAGEMENT LLC
Entity Type:Organization
Organization Name:ORLANDO MANAGEMENT LLC
Other - Org Name:TERRA VISTA REHAB AND HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF ACCOUNTING
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SHARPLESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-874-6007
Mailing Address - Street 1:1730 LUCERNE TER
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2917
Mailing Address - Country:US
Mailing Address - Phone:407-423-1612
Mailing Address - Fax:
Practice Address - Street 1:1730 LUCERNE TER
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2917
Practice Address - Country:US
Practice Address - Phone:407-423-1612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-02
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF1395096314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL026161100Medicaid
FL5189690001Medicare NSC
FL026161100Medicaid