Wildwood SNF LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1588096 Issued in FL

Legal business name

WILDWOOD SNF LLC

Practice address

490 S Old Wire Rd
Wildwood, FL 34785-5001

Phone

(352) 748-7609

NPI assigned

Feb 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ron Ostroff

Title

Owner

Phone

(954) 358-1660

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1174599674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7491 WEST OAKLAND BLVD.",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "33319",
            "telephone_number": "954-358-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 S OLD WIRE RD",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347855001",
            "telephone_number": "352-748-7609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDWOOD SNF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-24",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "OSTROFF",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-358-1660"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1588096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028314200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Wildwood, FL
• Providers in Wildwood, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.