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1120 West Donegan Avenue Operations Llc

1120 West Donegan Avenue Operations Llc is a health care provider in Kissimmee, FL. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 1120 W Donegan Ave, Kissimmee, FL 34741-2247, US
Practice Location Phone407-847-2854
Practice Location Fax407-994-4184
Legal Business Name1120 WEST DONEGAN AVENUE OPERATIONS LLC
Other Organization NameKEYSTONE REHABILITATION AND HEALTH CENTER
Other Organization Name TypeDoing Business As Name
NPI ?1245509058
Entity TypeOrganization
Enumeration Date ? Dec 22, 2011
Last Update Date ? May 10, 2019
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of 1120 West Donegan Avenue Operations Llc

SpecialtySpecializationLicenseLicense State
Skilled Nursing Facility SNF130471039Florida

legacy-id-icon Legacy Provider IDs of 1120 West Donegan Avenue Operations Llc

Provider IdIssuer StateIssuer TypeIssuer
004383900FloridaMedicaid

official-icon Authorized Official of 1120 West Donegan Avenue Operations Llc

An authorized official is an appointed official with the legal authority to make changes and/or updates to the 1120 West Donegan Avenue Operations Llc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Kenneth Ussery
Authorized Official Title/PositionVP
Authorized Official Phone Number407-571-1550