Port Orange Nursing & Rehab Center
LBN: Sovereign Healthcare Of Port Orange, Llc
Port Orange Nursing & Rehab Center is an health care organization with primary practice located at 5600 Victoria Gardens Blvd , Port Orange FL 32127-7914. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty.
Sovereign Healthcare Of Port Orange, Llc can be contacted via phone (386) 760-7773, or through Cronquist, R. Mark via phone (404) 574-2100.
Contact Information
Primary practice address
5600 Victoria Gardens Blvd
Port Orange FL 32127-7914
Phone: (386) 760-7773
Fax: (386) 760-8949
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Skilled Nursing Facility | 314000000X | SNF130471000 | Florida |
Profile Details
| NPI number | 1710974423 |
|---|---|
| LBN Legal business name | Sovereign Healthcare Of Port Orange, Llc |
| DBA Doing business as | Port Orange Nursing & Rehab Center |
| Authorized official | Cronquist, R. Mark |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 29th, 2005 |
| Last updated | Sep 24th, 2014 - about 10 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710974423 | NPPES |
| Florida | MEDICAID | 026350800 | |
| Florida | Other | V573P-6386 |
Popular Providers
-
John Knox Village Of Central Florida, Inc
901 Veterans Memorial Parkway , Orange City FL 32763-6167 -
Orange Park Mgt, Llc
833 Kingsley Ave , Orange Park FL 32073-4701 -
Life Care Centers Of America, Inc.
355 Crossing Blvd , Orange Park FL 32073-2860 -
Orange Park Extended Care Llc
1125 Fleming Plantation Blvd , Orange Park FL 32003-3389 -
Heartland Of Orange Park Fl Llc
570 Wells Rd , Orange Park FL 32073-2999 -
Orange Park Nursing Llc
833 Kingsley Ave , Orange Park FL 32073-4701 -
Sv - Jupiter Properties Inc
833 Kingsley Ave , Orange Park FL 32073-4701 -
Ambassador Rehabilitative Services
1215 Kingsley Ave , Orange Park FL 32073-4631