Provider Demographics
NPI:1386750420
Name:HCR MANORCARE MEDICAL SERVICES OF FLORIDA LLC
Entity type:Organization
Organization Name:HCR MANORCARE MEDICAL SERVICES OF FLORIDA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAZARUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-252-5518
Mailing Address - Street 1:333 N SUMMIT ST
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-2615
Mailing Address - Country:US
Mailing Address - Phone:419-252-6018
Mailing Address - Fax:800-564-5952
Practice Address - Street 1:333 N SUMMIT ST
Practice Address - Street 2:7TH FLOOR
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-2615
Practice Address - Country:US
Practice Address - Phone:419-252-6018
Practice Address - Fax:800-564-5952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD665MMedicare PIN
MDG01276Medicare PIN
WI000046251Medicare PIN
PA086776Medicare PIN
FL40600CMedicare PIN
MIOP11290Medicare PIN
IL211362Medicare PIN
OH9349451Medicare PIN
WI000040201Medicare PIN
FL40600AMedicare PIN
FL40600BMedicare PIN
IL211360Medicare PIN
IL211361Medicare PIN
OK400522481Medicare PIN
VAG02048Medicare PIN
IAI15780Medicare PIN
PA086777Medicare PIN
IN234370Medicare PIN
DCG01276Medicare PIN
MIOP11300Medicare PIN
COC802461Medicare PIN