HCR Manor Care Services of Florida III, LLC

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

Legal business name

HCR MANOR CARE SERVICES OF FLORIDA III, LLC

Practice address

150 S Pine Island Rd Ste 540
Plantation, FL 33324-2667

Phone

(954) 467-7423

NPI assigned

Apr 19, 2022

Organization subpart

Yes

Parent organization

HCR MANOR CARE SERVICES OF FLORIDA III, LLCAs reported in NPPES

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

Authorized official

Name

Martin David Allen

Title

Sole Director

Phone

(419) 252-5734

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ProMedica Hospice (Broward) Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• HCR Manor Care Services of Florida III, LLC

  • Community Based Hospice Care Agency
  • Plantation, FL
  • NPI 1063167146

  O20200807002050

  Same enrollment
• HCR Manor Care Services of Florida III, LLC

  • Community Based Hospice Care Agency
  • Plantation, FL
  • NPI 1669768594

  O20200807002050

  Same enrollment

Part of

HCR Manor Care Services of Florida III LLC

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1780327478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10086",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436990086",
            "telephone_number": "567-585-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S PINE ISLAND RD STE 540",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242667",
            "telephone_number": "954-467-7423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HCR MANOR CARE SERVICES OF FLORIDA III, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HCR MANOR CARE SERVICES OF FLORIDA III, LLC",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "SOLE DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003815300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Broward)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Arlene E Haywood, M.D.
• Einbar Hazan
• Monica Lauren Hazien, OD
• HCR Manor Care Services of Florida III, LLC
• HCR Manor Care Services of Florida III, LLC
• Chong He, AP2713
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• Hospice and Palliative Medicine (Internal Medicine) Physician in Plantation, FL
• Providers in Plantation, FL by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.