Organization
3865 TAMPA ROAD LLC
Active
Parent organization
SUNBRIDGE HEALTHCARE LLC
Other names
West Bay of Tampa
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUNBRIDGE HEALTHCARE LLC
Authorized official
MICHAEL THEODORE BERG (VP AND ASST SECRETARY)
(505) 468-4742
Entity
Organization
Contact information
Practice address
3865 TAMPA RD, OLDSMAR, FL 34677-3008
(813) 855-4661
(813) 854-2129
Mailing address
101 SUN AVE NE, COMPLIANCE DEPARTMENT, ALBUQUERQUE, NM 87109-4373
(505) 468-5604
(505) 468-4681
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF 1591096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025346400
—
FL
Enumeration date
07/26/2006
Last updated
03/23/2018
About Stedi
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