12170 Cortez Blvd Opco LLC – Skilled Nursing Facility

Key facts

NPI: 1508638834
Entity type: Organization (NPI type 2)
Primary specialty: Skilled Nursing Facility 314000000X
Legal business name: 12170 CORTEZ BLVD OPCO LLC
Practice address: 12170 Cortez Blvd
Brooksville, FL 34613-5578
Phone: (352) 597-5100
Fax: (352) 597-5020
NPI assigned: Oct 30, 2023
Organization subpart: No

Authorized official

Name: Nathan Freund
Title: Manager
Phone: (732) 730-7480

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Stefan Samuel Mann, MD Family Medicine Physician · Gainesville, FL · NPI 1356847388

CMS ownership ADP OF THE SNF · OPERATIONAL/MANAGERIAL CONTROL

Affiliated clinicians 4

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

Mercely Rani Devabavus, M.D Internal Medicine Physician · Spring Hill, FL · NPI 1164611349

Care Compare affiliation Nursing home
Abdel Karim Jibawi, M.D. Family Medicine Physician · Hudson, FL · NPI 1912261876

Care Compare affiliation Nursing home
Pornchai Kittivarakarn, D.O. Internal Medicine Physician · Hudson, FL · NPI 1427436385

Care Compare affiliation Nursing home
Michael Rudelli, MD General Practice Physician · St Petersburg, FL · NPI 1184260283

Care Compare affiliation Nursing home

Medicare Care Compare: Nursing home

Listed as: Aviata at Spring Hill CCN 105996
Overall star rating: ★★★★☆ 4 of 5
Health inspections: ★★★☆☆ 3 of 5
Staffing: ★★☆☆☆ 2 of 5
Quality measures: ★★★★★ 5 of 5
Type: Medicare and Medicaid
Ownership: For profit - Limited Liability company
Certified: Oct 7, 1998
Medicare certification status: Active (Provider of Services file)
Certified beds: 120 · 117.1 residents per day on average
Chain: Aviata Health Group (50 facilities)

Source: Medicare Care Compare, processed Aug 1, 2026.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
10D0929416	Aviata at Spring Hill 12170 Cortez Blvd, Brooksville, FL 34613	Certificate of waiver	Jun 12, 2027

Medicare participation

Medicare fee-for-service enrollment: Enrolled in FL

Skilled nursing facility certification: CCN 105996

Legal name: 12170 CORTEZ BLVD OPCO LLC
Doing business as: AVIATA AT SPRING HILL
Certification status: Active
Provider type (POS): Nursing home – SNF/NF distinct part
Participating since: Oct 7, 1998
Last certification: Apr 24, 2025
Beds: 120
Ownership / control type: Limited Liability Corporation
Multi-facility organization: Aspire Health Group
Most recent change of ownership: Dec 1, 2023
Organization structure: LLC · Proprietary
Incorporated: Oct 12, 2023 in FL
Enrollment address: 12170 Cortez Blvd
Brooksville, FL 34613-5578
Nursing home name: AVIATA AT SPRING HILL
Affiliated entity: AVIATA HEALTH GROUP

All disclosed owners & managing parties 9

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

Name	Role	Since	Share
Stefan Samuel Mann Individual	Operational/Managerial Control	Dec 27, 2024
Stefan Samuel Mann Individual	Adp of the SNF	Dec 27, 2024
12170 Cortez Blvd Opco Parent LLC Organization · Jackson, NJ Created for acquisition, LLC, For-profit, Owned by another organization or individual	Direct Ownership Interest	Dec 1, 2023	100%
12170 Cortez Blvd Opco Holdco LLC Organization · Jackson, NJ Created for acquisition, LLC, For-profit, Owned by another organization or individual	Indirect Ownership Interest	Dec 1, 2023	100%
Aspire MGT LLC Organization · Jackson, NJ LLC, For-profit, Chain home office	Adp of the SNF	Dec 1, 2023
Nochum Freund Individual	Corporate Officer Coo	Dec 1, 2023
Nochum Freund Individual	Operational/Managerial Control	Dec 1, 2023
Organization · Brooklyn, NY	Adp of the SNF	Jul 20, 2025
Organization · Springfield, MO	Adp of the SNF	Jul 20, 2025
Gabriella Diaz Individual	Operational/Managerial Control	May 13, 2024
Gabriella Diaz Individual	Adp of the SNF	May 13, 2024
Organization · Lakewood, NJ LLC	Adp of the SNF	Jul 2, 2025

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20240304002148	FL	Part a Provider - Skilled Nursing Facility	5193160836	Practice locations: Brooksville, FL

National Provider Directory

Networks

Freedom Health HMO Network
Plans: 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 Maximo (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 Network
Plans: 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)

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Skilled Nursing Facility	314000000X			Yes

Addresses

Primary practice location

12170 Cortez Blvd
Brooksville, FL 34613-5578

Mailing address

12170 Cortez Blvd
Brooksville, FL 34613-5578
Phone (352) 597-5100

Other names

Aviata at Spring Hill Doing business as

Electronic endpoints

Type	Endpoint	Use	Affiliation
CONNECT URL	https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service	Other	Consulate Health Care

Other providers in Brooksville, FL

All providers in Brooksville, FL · Skilled Nursing Facility in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
Provider of Services files (CMS): certification status, beds and related CCNs.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.