1306830260 NPI number — THE HEALTH CENTER OF STUART, INC.

Table of content: (NPI 1306830260)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306830260 NPI number — THE HEALTH CENTER OF STUART, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE HEALTH CENTER OF STUART, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PARKWAY HEALTH & REHAB CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306830260
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 SE CENTRAL PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STUART
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34994-3901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
772-287-9912
Provider Business Mailing Address Fax Number:
772-221-7250

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 SE CENTRAL PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STUART
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34994-3901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
772-287-9912
Provider Business Practice Location Address Fax Number:
772-221-7250
Provider Enumeration Date:
09/07/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WINTERS
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
C.
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
772-287-9912

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  SNF1361096 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)