11565 Harts Road Operations LLC
Organization Active NPI Skilled Nursing Facility · Jacksonville, FL
NPI 1669741302 · NPPES record last updated Sep 13, 2024
Key facts
- NPI
- 1669741302
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- SNF15640961 (FL)
- Legal business name
- 11565 HARTS ROAD OPERATIONS LLC
- Practice address
- 11565 Harts Rd
Jacksonville, FL 32218-3777 - Phone
- (904) 751-1834
- Fax
- (904) 751-0272
- NPI assigned
- Dec 27, 2011
- Organization subpart
- No
Authorized official
- Name
- Miriam C. Pastor
- Title
- Manager
- Phone
- (786) 457-2383
Practitioners 1
-
Arlene Aquino, APRN
National Provider Directory
Locations
11565 Harts Rd
Jacksonville, FL 32218
Phone (904) 571-1834
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | SNF15640961 | FL | Yes |
Addresses
Primary practice location
11565 Harts Rd
Jacksonville, FL 32218-3777
Mailing address
11565 Harts Rd
Jacksonville, FL 32218-3777
Phone (904) 751-1834
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004386500 | Medicaid | FL |
Other names
- Harts Harbor Health Care Center
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service | Other |
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All providers in Jacksonville, 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 Sep 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.