Organization
626 NORTH TYNDALL PARKWAY OPERATIONS LLC
Active
Other names
Emerald Shores Health and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH USSERY (VP)
(407) 571-1550
Entity
Organization
Contact information
Practice address
626 N TYNDALL PKWY, CALLAWAY, FL 32404-6132
(850) 871-6363
(850) 871-6367
Mailing address
626 N TYNDALL PKWY, CALLAWAY, FL 32404-6132
(850) 871-6363
(850) 871-6367
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF1292096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006097200
—
FL
Enumeration date
12/27/2011
Last updated
11/27/2023
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