Provider Demographics
NPI:1396753935
Name:SOUTH BEACH NURSING AND REHABILITATION CENTER, INC.
Entity type:Organization
Organization Name:SOUTH BEACH NURSING AND REHABILITATION CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUBKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-790-9019
Mailing Address - Street 1:42 COLLINS AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-7314
Mailing Address - Country:US
Mailing Address - Phone:305-672-1771
Mailing Address - Fax:305-672-5940
Practice Address - Street 1:42 COLLINS AVE
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-7314
Practice Address - Country:US
Practice Address - Phone:305-672-1771
Practice Address - Fax:305-672-5940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF1507096314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105229Medicare ID - Type UnspecifiedPROVIDER NUMBER