Organization
VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS PATRICIA RENEE ANDERSON (RN)
(386) 916-6755
Entity
Organization
Contact information
Practice address
1920 MASON AVE, EMORY L BENNETT VA NURSING HOME, DAYTONA BEACH, FL 32117-5103
(386) 274-3460
Mailing address
16840 SE 52ND PL, OCKLAWAHA, FL 32179-2836
(386) 916-6755
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
RN2047752
FL
Other
Enumeration date
08/16/2007
Last updated
08/16/2007
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