Brandywine Convalescent Center Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF10600961 Issued in FL

Legal business name

BRANDYWINE CONVALESCENT CENTER INC

Doing business as

Brandywyne Health Care Center

Practice address

1801 Lake Mariam Dr
Winter Haven, FL 33884-0927

Phone

(863) 293-1989

Fax

(863) 299-6427

NPI assigned

Dec 2, 2005

Organization subpart

No

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

Authorized official

Name

Victoria Lynn Sharpless

Title

Director of Accounting

Phone

(352) 874-6007

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brandywyne Health Care Center Doing business as

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1518941582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 LAKE MARIAM DR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338840927",
            "telephone_number": "863-293-1989",
            "fax_number": "863-299-6427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 LAKE MARIAM DR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338840927",
            "telephone_number": "863-293-1989",
            "fax_number": "863-299-6427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDYWINE CONVALESCENT CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-02",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "SHARPLESS",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DIRECTOR OF ACCOUNTING",
        "authorized_official_telephone_number": "352-874-6007"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF10600961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025139900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brandywyne Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brandywyne Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cynthia Boyzo
• Joseph J Bradfield, M.D.
• Wilma Mae Bradshaw-Mims, L.C.S.W.
• Kayshia Brady, ATC
• Krischell Scarleth Brand, MA73471
• Brandywyne Assisted Living Facility, LLC.
• Lisa Ann Branscum, OTR
• Sonya Braudway, O.D.
• Katherine Breeden
• Haylee Brescia, SLPA

• Skilled Nursing Facility in Winter Haven, FL
• Providers in Winter Haven, 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 Oct 8, 2020; 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.