Organization
INDIAN RIVER CENTER, LLC
Active
Other names
Indian River Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MONICA TERRANO (CHIEF FINANCIAL OFFICER)
(819) 852-7000
Entity
Organization
Contact information
Practice address
7201 GREENBORO DR, WEST MELBOURNE, FL 32904-1698
(321) 727-0990
(321) 951-4553
Mailing address
7201 GREENBORO DR, WEST MELBOURNE, FL 32904-1698
(321) 727-0990
(321) 951-4553
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF1348096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005900226
AETNA
FL
05
—
026066500
—
FL
01
—
08845
BLUE CROSS BLUE SHIELD MI
MI
01
—
70-00474
EVERCARE HH CONNECTION
FL
01
—
C105673
UNITED AMERICAN
FL
01
—
K3M
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/13/2005
Last updated
02/27/2024
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