Fountain Inn Nursing & Rehabilitation Center Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FOUNTAIN INN NURSING & REHABILITATION CENTER INC

Doing business as

AdventHealth Care Center Waterman

Practice address

4501 Waterman Way
Tavares, FL 32778

Phone

(352) 609-4000

NPI assigned

May 25, 2018

Organization subpart

No

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

Authorized official

Name

Mr. David Rodman

Title

Asst Secretary of the Board

Phone

(407) 975-3011

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• AdventHealth Care Center Waterman Doing business as

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1437640471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 HOPE WAY",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327141502",
            "telephone_number": "407-975-3000",
            "fax_number": "407-975-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "32778",
            "telephone_number": "352-609-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN INN NURSING & REHABILITATION CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-25",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "RODMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "ASST SECRETARY OF THE BOARD",
        "authorized_official_telephone_number": "407-975-3011",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100964700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AdventHealth Care Center Waterman",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alice Louise Floyd, ARNP, CWCN
• Maria Flynn, MD
• Judy Joan Forrester, D.M.D.
• Marie Fors, LMFT
• Catherine Forsyth
• Michael Warren Fountain, D.O.
• Moises Fraifeld, MD
• Janith Frances
• Lula M Frazier
• Patricia Ann Frazier, RD LD

• Skilled Nursing Facility in Tavares, FL
• Providers in Tavares, 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 Nov 27, 2023; 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.