Provider Demographics
NPI:1790396489
Name:CENTER FOR AGING AND REHABILITATION OF SARASOTA INC
Entity Type:Organization
Organization Name:CENTER FOR AGING AND REHABILITATION OF SARASOTA INC
Other - Org Name:BREEZE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:H
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-367-4597
Mailing Address - Street 1:100 SE 2ND ST STE 2000
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-2101
Mailing Address - Country:US
Mailing Address - Phone:954-367-4597
Mailing Address - Fax:954-367-4597
Practice Address - Street 1:1755 18TH ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-8657
Practice Address - Country:US
Practice Address - Phone:419-554-9159
Practice Address - Fax:941-366-9455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-14
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGMedicaid