Wildwood SNF LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1588096 Issued in FL

Legal business name

WILDWOOD SNF LLC

Doing business as

Arbor Village Nursing Center

Practice address

490 S Old Wire Rd
Wildwood, FL 34785-5001

Phone

(352) 748-3322

Fax

(352) 748-7609

NPI assigned

Jul 12, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Tzvi Bogomilsky

Title

Authorized Official

Phone

(305) 401-7901

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Arbor Village Nursing Center Doing business as

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380844800000",
    "number": "1770782583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 NE MIAMI GARDENS DR",
            "address_2": "#368",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331795035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 S OLD WIRE RD",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347855001",
            "telephone_number": "352-748-3322",
            "fax_number": "352-748-7609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDWOOD SNF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2013-10-04",
        "status": "A",
        "authorized_official_last_name": "BOGOMILSKY",
        "authorized_official_first_name": "TZVI",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "305-401-7901",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1588096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032504000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arbor Village Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Wildwood, FL
• Providers in Wildwood, 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 4, 2013; 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.