Organization
SA-PG PINELLAS, LLC
Active
Other names
Palm Garden of Pinellas
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE WERTHEIM (CFO)
(914) 390-4322
Entity
Organization
Contact information
Practice address
200 16TH AVE SE, LARGO, FL 33771-4400
(727) 585-9377
(727) 588-9038
Mailing address
200 16TH AVE SE, LARGO, FL 33771-4400
(727) 585-9377
(727) 588-9038
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF1418095
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025750800
—
FL
Enumeration date
06/22/2005
Last updated
07/23/2008
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