Organization
DOS OF EDEN SPRINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JORGE R HERNANDO (CFO)
(305) 868-1830
Entity
Organization
Contact information
Practice address
4679 CRAWFORDVILLE HWY, CRAWFORDVILLE, FL 32327-4539
(850) 926-7181
(850) 926-3064
Mailing address
4679 CRAWFORDVILLE HWY, CRAWFORDVILLE, FL 32327-4539
(850) 926-7181
(850) 926-3064
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF1582096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025370700
—
FL
Enumeration date
09/16/2006
Last updated
05/21/2008
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