Pinecrest Convalescent Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

14400961 Issued in FL

Legal business name

PINECREST CONVALESCENT CENTER, LLC

Doing business as

Pinecrest Rehabilitation Center

Practice address

13650 NE 3Rd CT
North Miami, FL 33161-3626

Phone

(305) 893-1170

Fax

(305) 899-2817

NPI assigned

Aug 8, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David Gold, LCSW, MBA

Title

Administrator

Phone

(305) 893-1170

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Pinecrest Rehabilitation Center Doing business as

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 Maximo (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)…

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422316800000",
    "number": "1871503417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13650 NE 3RD CT",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331613626",
            "telephone_number": "305-893-1170",
            "fax_number": "305-899-2817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13650 NE 3RD CT",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331613626",
            "telephone_number": "305-893-1170",
            "fax_number": "305-899-2817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINECREST CONVALESCENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2015-01-27",
        "status": "A",
        "authorized_official_last_name": "GOLD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "305-893-1170",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW, MBA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "13413",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "14400961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022575400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinecrest Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Physicians Group of South Florida PA
• Vanessa Pierre-Louis, RPH, CPH
• Gerardine Pierre
• Guirlande Pierre
• Chantal Michelle Venilia Pina Gomes
• Pinecrest SNF Operations LLC
• Yordana Pineda Napoles
• Maria E Pinedo, RBT-24-335058
• Pinel Medical Center
• Pinel Medical Center Inc

• Skilled Nursing Facility in North Miami, FL
• Providers in North Miami, 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 Jan 27, 2015; 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.