Organization
BRANDON FACILITY OPERATIONS LLC
Active
Other names
Raydiant Health Care of Brandon
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH USSERY (VP)
(407) 571-1550
Entity
Organization
Contact information
Practice address
701 VICTORIA ST, BRANDON, FL 33510-4100
(813) 681-4220
(813) 689-5685
Mailing address
701 VICTORIA ST, BRANDON, FL 33510-4100
(813) 681-4220
(813) 689-5685
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF1577096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008037700
—
FL
Enumeration date
07/25/2006
Last updated
12/22/2021
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