Provider Demographics
NPI:1881861052
Name:HCR MANOR CARE MEDICAL SERVICES OF FLORIDA LLC
Entity Type:Organization
Organization Name:HCR MANOR CARE MEDICAL SERVICES OF FLORIDA LLC
Other - Org Name:HEARTLAND CARE PARTNERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAZARUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-252-5518
Mailing Address - Street 1:333 N SUMMIT ST FL 7
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-2615
Mailing Address - Country:US
Mailing Address - Phone:419-252-6018
Mailing Address - Fax:800-564-5952
Practice Address - Street 1:333 N SUMMIT ST FL 7
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-1531
Practice Address - Country:US
Practice Address - Phone:419-252-6018
Practice Address - Fax:800-564-5952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1020651050001Medicaid
PADC7142OtherRAILROAD MEDICARE
PADC7141OtherRAILROAD MEDICARE
PADC7142OtherRAILROAD MEDICARE