Provider Demographics
NPI:1194771022
Name:RIO PINAR HEALTH CARE ASSOCIATES LLC
Entity type:Organization
Organization Name:RIO PINAR HEALTH CARE ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSSARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-658-2046
Mailing Address - Street 1:7950 LAKE UNDERHILL RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-8229
Mailing Address - Country:US
Mailing Address - Phone:407-658-2046
Mailing Address - Fax:407-249-2226
Practice Address - Street 1:7950 LAKE UNDERHILL RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8229
Practice Address - Country:US
Practice Address - Phone:407-658-2046
Practice Address - Fax:407-249-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF14370961314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL025245000Medicaid
105564Medicare Oscar/Certification