Provider Demographics
NPI:1770734923
Name:OSCEOLA NURSING AND REHABILITATION INC
Entity type:Organization
Organization Name:OSCEOLA NURSING AND REHABILITATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-420-2090
Mailing Address - Street 1:4201 W NEW NOLTE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34772-7100
Mailing Address - Country:US
Mailing Address - Phone:407-957-3341
Mailing Address - Fax:
Practice Address - Street 1:4201 W NEW NOLTE RD
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34772-7100
Practice Address - Country:US
Practice Address - Phone:407-957-3341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10-5734OtherMEDICARE PROVIDER NUMBER