Organization
WILLISTON REHABILITATION AND NURSING CENTER LLC
Active
Other names
Williston Rehabilitation and Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
TZVI BOGOMILSKY (MEMBER)
(305) 401-7901
Entity
Organization
Contact information
Practice address
300 NW 1ST AVE, WILLISTON, FL 32696-2006
(352) 528-3561
Mailing address
1835 NE MIAMI GARDENS DR, #368, NORTH MIAMI BEACH, FL 33179-5035
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031758600
—
FL
Enumeration date
08/28/2006
Last updated
08/20/2013
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