702 S Kings Ave Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

702 S KINGS AVE OPCO LLC

Doing business as

Aviata at Central Park

Practice address

702 S Kings Ave
Brandon, FL 33511-5925

Phone

(813) 651-1818

Fax

(813) 654-4252

NPI assigned

Oct 30, 2023

Last updated

Apr 9, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nathan Freund

Title

Manager

Phone

(732) 730-7480

Specialties & licenses 1

Addresses

Other names 1

• Aviata at Central Park Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720850035. Details of each certification follow.

• CCN 105718 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 105718

Legal name

702 S KINGS AVE OPCO LLC

Doing business as

AVIATA AT CENTRAL PARK

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF distinct part

Participating since

Feb 25, 1991

Last certification

Jan 25, 2024

Beds

120

Ownership / control type

Corporation

Most recent change of ownership

Dec 1, 2023

Organization structure

LLCProprietary

Enrollment address

702 S Kings Ave
Brandon, FL 33511-5925

Nursing home name

AVIATA AT CENTRAL PARK

Affiliated entity

AVIATA HEALTH GROUP

Listed as

Aviata at Central ParkCCN 105718 · All quality measures

Overall star rating

3 of 5

Health inspections

2 of 5

Staffing

2 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Feb 25, 1991

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

120116.8 residents per day on average

Chain

Aviata Health Group50 facilities in the chain

Penalties (3 years)

2Fines totaling $7,456

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Networks

• Freedom Health HMO NetworkPlans: 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 Máximo (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 NetworkPlans: 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)

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.

Owners & managing parties with NPI records 1

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

• Vanessa Veve, M.D

  • Geriatric Medicine (Internal Medicine) Physician
  • Tampa, FL
  • NPI 1558395574

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vanessa Veve, M.D

  • Geriatric Medicine (Internal Medicine) Physician
  • Tampa, FL
  • NPI 1558395574
  NPD (past)

Affiliated clinicians 4

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

• German Alvarez, M.D.

  • Family Medicine Physician
  • Brandon, FL
  • NPI 1619141231

  Nursing home

  Care Compare affiliation
• Prudhvi Rajan Karumanchi, M.D., M.P.H.

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1477723781

  Nursing home

  Care Compare affiliation
• Henry A Odukomaiya, M.D.

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1740254184

  Nursing home

  Care Compare affiliation
• Vanessa Veve, M.D

  • Geriatric Medicine (Internal Medicine) Physician
  • Tampa, FL
  • NPI 1558395574

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1698624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1720850035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 S KINGS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115925",
            "telephone_number": "813-651-1818",
            "fax_number": "813-654-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 S KINGS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115925",
            "telephone_number": "813-651-1818",
            "fax_number": "813-654-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "702 S KINGS AVE OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-30",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A",
        "authorized_official_last_name": "FREUND",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "732-730-7480"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.5042",
            "affiliationName": "Consulate Health Care",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "850 Concourse Pkwy S Ste 250",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327516155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Aviata at Central Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Brandon, FL
• Providers in Brandon, 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 Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (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.