Organization
LAKE PARK SNF LLC
Active
Other names
North Lake Rehabilitation and Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TZVI BOGOMILSKY (AUTHORIZED OFFICIAL)
(305) 401-7901
Entity
Organization
Contact information
Practice address
750 BAYBERRY DR, LAKE PARK, FL 33403-3248
(561) 881-8144
(561) 844-8352
Mailing address
1835 NE MIAMI GARDENS DR, #368, NORTH MIAMI BEACH, FL 33179-5035
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032516300
—
FL
Enumeration date
07/13/2007
Last updated
07/10/2013
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