Provider Demographics
NPI:1376342246
Name:TARPON OPCO LLC
Entity type:Organization
Organization Name:TARPON OPCO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEF
Authorized Official - Middle Name:
Authorized Official - Last Name:CUKIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-200-1155
Mailing Address - Street 1:5157 PARK CLUB DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34235-1801
Mailing Address - Country:US
Mailing Address - Phone:941-377-0022
Mailing Address - Fax:
Practice Address - Street 1:5157 PARK CLUB DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34235-1801
Practice Address - Country:US
Practice Address - Phone:941-377-0022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-12
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility