CARROLLWOOD REHABILITATION CENTER LLC (NPI# 1457846453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457846453 |
| Entity Type | Organization |
| Organization Name | CARROLLWOOD REHABILITATION CENTER LLC |
| Other Organization Name | NORTHDALE REHABILITATION CENTER |
| Practice Address |
3030 W Bearss Ave Tampa FL 33618-1811 |
| Mailing Address |
101 Sunnytown Rd Ste 201 Casselberry FL 32707-3862 |
| Practice Telephone | 8136988777 |
| Mailing Telephone | 4078305309 |
| Mailing Fax Number | 4078307775 |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2019-07-29 |
| Authorized Official Name | MR. DON MELTON (CFO) |
| Authorized Official Telephone | 4078305309 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOVEREIGN HEALTHCARE HOLDINGS, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Northdale Rehabilitation Center | Doing Business As Name - Organization |
| Street Address |
3030 W BEARSS AVE |
| City | TAMPA |
| State | FL |
| Zip Code | 33618-1811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649227414 | Manor Care - Carrollwood of Tampa Fl, LLC | Skilled Nursing Facility | 3030 W Bearss Ave, Tampa, FL 33618-1811 | 2006-05-27 |
| 1134669112 | Jennifer Tribue | Nurse Practitioner | 3030 W Bearss Ave, Tampa, FL 33618-1811 | 2017-02-24 |
| 1194913285 | Sylvia Merly | Occupational Therapist | 3030 W Bearss Ave, Tampa, FL 33618-1811 | 2007-10-15 |
| 1639288137 | Jon Paul Gaudino | Physical Medicine & Rehabilitation | 3030 W Bearss Ave, Tampa, FL 33618 | 2006-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730714130 | Virgin Mary's Pharmacy | Pharmacy | 14606 N Dale Mabry, Tampa, FL 33618 | 2020-03-05 |
| 1801378252 | Leah Rae Petit | Nurse Practitioner | 3505, 11809 N Dale Mabry Hwy, Tampa, FL 33618 | 2018-09-02 |
| 1265921100 | Almighty Home Healthcare Services, Inc. | Home Health | 16614 N. Dale Mabry Hwy, Tampa, FL 33618 | 2018-05-07 |
| 1972016368 | Pepe C Mcneal | Specialist | 15241 North Dalemabry Ave, Sola Salons (studio #14, Tampa, FL 33618 | 2017-11-08 |
| 1760919179 | Sara Ashley Carr | Counselor | 10014 N Dale Mabry Hwy Ste 216, Tampa, FL 33618 | 2017-05-16 |
| 1073975231 | National Vision, Inc. | Technician/Technologist | 10934 N Dale Mabry Hwy, Carrollwood, FL 33618 | 2016-03-25 |
| 1003209792 | Tampa General Medical Group Inc | Internal Medicine | 3419 N Lakeview Dr, Tampa, FL 33618 | 2015-03-05 |
| 1114205648 | Liberty Medical Solutions, LLC | Durable Medical Equipment & Medical Supplies | 3653 Madaca Ln, Tampa, FL 33618 | 2011-08-02 |
| 1386938215 | David Leonardo Higuera | Pharmacist | 2901 W Bush Blvd, Suite 104, Tampa, FL 33618 | 2011-06-08 |
| 1922303973 | Kimberly Lynne Little | Social Worker | 3044 W. Bearss Avenue, Tampa, FL 33618 | 2011-01-24 |
| Find all providers in zip 33618 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265846174 | Riverwood Health Nh LLC | Skilled Nursing Facility | 4042 Park Oaks Blvd Ste 300, Tampa, FL 33610-9539 | 2014-06-18 |
| 1710317532 | Bvm Lakeshore LLC | Skilled Nursing Facility | 16001 Lakeshore Villa Drive, Tampa, FL 33613 | 2013-11-14 |
| 1952677908 | Geidy Hernandez | Skilled Nursing Facility | 5126 Net Dr, Tampa, FL 33634-5095 | 2012-03-23 |
| 1215163662 | Progressus Therapy | Skilled Nursing Facility | 10014 N Dale Mabry Hwy # C-100, Tampa, FL 33618-4426 | 2009-05-29 |
| 1518126408 | Sf Tampa LLC | Skilled Nursing Facility | 1818 East Fletcher Avenue, Tampa, FL 33612-3770 | 2008-06-05 |
| 1568546513 | Canterbury Tower Inc. | Skilled Nursing Facility | 3501 Bayshore Blvd, Tampa, FL 33629-8901 | 2006-10-25 |
| 1649227414 | Manor Care - Carrollwood of Tampa Fl, LLC | Skilled Nursing Facility | 3030 W Bearss Ave, Tampa, FL 33618-1811 | 2006-05-27 |
| 1932155918 | Fletcher Health Care Associates LLC | Skilled Nursing Facility | 518 W Fletcher Ave, Tampa, FL 33612-3419 | 2006-05-25 |
| 1699728626 | Solomon Holdings I - The Triangle LLC | Skilled Nursing Facility | 16702 N Dale Mabry Hwy, Tampa, FL 33618-1055 | 2006-05-19 |
| 1316916281 | Tr & Snf Inc | Skilled Nursing Facility | 12250 N 22nd St, Tampa, FL 33884 | 2006-03-14 |
| Find all providers in TAMPA | ||||
Please comment or provide details below to improve the information on CARROLLWOOD REHABILITATION CENTER LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.