Provider Demographics
NPI:1881861060
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 1:3425 EXECUTIVE PKWY
Mailing Address - Street 2:SUITE 131
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1326
Mailing Address - Country:US
Mailing Address - Phone:419-531-2127
Mailing Address - Fax:419-531-2664
Practice Address - Street 1:3425 EXECUTIVE PKWY
Practice Address - Street 2:SUITE 131
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1326
Practice Address - Country:US
Practice Address - Phone:419-531-2127
Practice Address - Fax:419-531-2664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCK6045OtherRAILROAD MEDICARE
FLCK6045OtherRAILROAD MEDICARE