Organization
NORTHPORT HEALTH SERVICES OF FLORIDA, LLC
Active
Other names
West Melbourne Health & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP CODY LONG (CFO)
(205) 391-3600
Entity
Organization
Contact information
Practice address
2125 W NEW HAVEN AVE, WEST MELBOURNE, FL 32904-3803
(321) 725-7360
Mailing address
2125 W NEW HAVEN AVE, WEST MELBOURNE, FL 32904-3803
(321) 725-7360
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF1593096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021772700
—
FL
Enumeration date
05/23/2006
Last updated
10/27/2020
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