MK of Winter Garden LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1456096 Issued in FL

Legal business name

MK OF WINTER GARDEN LLC

Practice address

12751 W Colonial Dr
Winter Garden, FL 34787-4113

Phone

(407) 877-6636

NPI assigned

Aug 7, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Tarry Harbilas

Title

Administrator

Phone

(407) 877-6636

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1689683443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12751 W COLONIAL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874113",
            "telephone_number": "407-877-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12751 W COLONIAL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874113",
            "telephone_number": "407-877-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MK OF WINTER GARDEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "HARBILAS",
        "authorized_official_first_name": "TARRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "407-877-6636",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1456096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02254100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miracle Health Ctr.of Winter Garden
• Dicciana Miranda
• Lorena Miranda, OD
• Jeanne Marie Louise Mirbey, DPM
• Annemarie Mistretta
• Diazina Mobley, LCSW
• Sarah Moghadas
• Tyler Mok
• Momentum Healing LLC
• Adam Money, M.D.

• Skilled Nursing Facility in Winter Garden, FL
• Providers in Winter Garden, 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 Jul 24, 2008; 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.