Provider Demographics
NPI:1104126374
Name:POST ACUTE CARE SPECIALIST, LLC
Entity type:Organization
Organization Name:POST ACUTE CARE SPECIALIST, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PERSAUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-657-6527
Mailing Address - Street 1:2170 W. STATE ROAD 434
Mailing Address - Street 2:SUITE 260
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-5009
Mailing Address - Country:US
Mailing Address - Phone:407-657-6527
Mailing Address - Fax:407-657-6570
Practice Address - Street 1:7975 LAKE UNDERHILL ROAD
Practice Address - Street 2:SUITE 240
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8202
Practice Address - Country:US
Practice Address - Phone:407-657-6527
Practice Address - Fax:407-657-6570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFD314AMedicare UPIN