Organization
702 SOUTH KINGS AVENUE OPERATIONS LLC
Active
Other names
Central Park Healthcare and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH USSERY (VP)
(407) 571-1550
Entity
Organization
Contact information
Practice address
702 S KINGS AVE, BRANDON, FL 33511-5925
(813) 651-1818
(813) 654-4252
Mailing address
702 S KINGS AVE, BRANDON, FL 33511-5925
(813) 651-1818
(813) 654-4252
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF1088096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004385600
—
FL
Enumeration date
12/22/2011
Last updated
11/27/2023
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