NPIMap

Organization Active NPI

Lakeland Nursing and Rehabilitation, LLC

  • Skilled Nursing Facility
  • Lakeland, FL
National Provider Identifier
1174999726
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LAKELAND NURSING AND REHABILITATION, LLC
Practice address
1919 Lakeland Hills Blvd
Lakeland, FL 33805-2901
Phone
(863) 688-5612
NPI assigned
Aug 18, 2015
Last updated
Aug 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Authorized official

Name
Moshe David Aryeh
Title
Member
Phone
(847) 440-2233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X FL Primary

Addresses

Primary practice location

1919 Lakeland Hills Blvd
Lakeland, FL 33805-2901

Mailing address

7383 N Lincoln Ave
Suite 100
Lincolnwood, IL 60712-1734
Phone (847) 440-2233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160505000674 FL Part A Provider - Skilled Nursing Facility 1052610565 Practice locations: Lakeland, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174999726. Details of each certification follow.

Skilled nursing facility certification: CCN 105354

Legal name
LAKELAND NURSING AND REHABILITATION LLC
Doing business as
LAKELAND NURSING AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
May 1, 1979
Last certification
Mar 2, 2023
Beds
185
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Aug 11, 2015 in FL
Enrollment address
1919 Lakeland Hills Blvd
Lakeland, FL 33805-2901
Nursing home name
VIVO HEALTHCARE LAKELAND
Affiliated entity
VIVO HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Vivo Healthcare LakelandCCN 105354 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
May 1, 1979
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
185171.5 residents per day on average
Chain
Vivo Healthcare12 facilities in the chain
Penalties (3 years)
13Fines totaling $152,495

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0723903Lakeland Nursing and Rehabilitation Center LLC1919 Lakeland Hills Blvd, Lakeland, FL 33805Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Zaidys LLC Organization, Lawrence, NY LLC, For-profit 5% Or Greater Indirect Ownership Interest Nov 16, 2017 30%
Allegiant Healthcare of Florida LLC Organization, Cedarhurst, NY Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 16, 2017 60%
Samuel Goldner Individual 5% Or Greater Indirect Ownership Interest Nov 16, 2017 30%
Brian Bentz Individual W-2 Managing EmployeeAdministrator Nov 16, 2017 100%
Solomon Vizcaya Holdings LLC Organization, Lawrence, NY Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 16, 2017 30%
Asmsy LLC Organization, Cedarhurst, NY LLC, For-profit 5% Or Greater Indirect Ownership Interest Nov 16, 2017 30%
Irving Langer 2014 Family Trust U/T/a Organization, Lawrence, NY 5% Or Greater Indirect Ownership Interest Nov 16, 2017 30%
Jacob Karmel Individual 5% Or Greater Indirect Ownership Interest Nov 16, 2017 10%
Palm Terrace J Dek Operations LLC Organization, Montebello, NY Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Mar 31, 2016 100%
Ariel S Fein Individual 5% Or Greater Indirect Ownership Interest Nov 16, 2017 28.5%

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 7

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1174999726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7383 N LINCOLN AVE",
            "address_2": "SUITE 100",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121734",
            "telephone_number": "847-440-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338052901",
            "telephone_number": "863-688-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND NURSING AND REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "ARYEH",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "847-440-2233"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.