• No results found

AHCA Medicaid Program Finance 7/10/15

N/A
N/A
Protected

Academic year: 2021

Share "AHCA Medicaid Program Finance 7/10/15"

Copied!
14
0
0

Loading.... (view fulltext now)

Full text

(1)

AHCA

County Medicaid Number Provider Name Address Line1 City State Zip Date Active Date Inactive

Suwannee [61] 001135 Surrey Place Care Center 110 SE LEE AVE LIVE OAK, FL 32060 6/1/2008

Palm Beach [50] 001136 Signature HealthCARE of Palm Beach 4405 LAKEWOOD ROAD LAKE WORTH, FL 33461 6/1/2008

Indian River [31] 001416 Florida Baptist Retirement Center 1006 33RD ST VERO BEACH, FL 32960 7/30/2008

Charlotte [8] 002400 Village Place Health and Rehab Center 2370 HARBOR BLVD PORT CHARLOTTE, FL 33952 9/30/2008

Osceola [49] 005219 Osceola Health Care Center 4201 W NEW NOLTE ROAD SAINT CLOUD, FL 34772 1/1/2009

Volusia [64] 005372 Debary Health and Rehabilitation Center 60 N HWY 17/92 DEBARY, FL 32713 12/4/2008

Flagler [18] 005374 Flagler Health And Rehabilitation Center 300 DR CARTER BOULEVARD BUNNELL, FL 32110 12/4/2008

Seminole [59] 005379 Longwood Health And Rehabilitation Center 1520 S GRANT ST LONGWOOD, FL 32750 12/4/2008

Orange [48] 005380 The Rehabilitation Center of Winter Park 1700 MONROE AVE MAITLAND, FL 32751 12/4/2008

Jefferson [33] 005381 Brynwood Health And Rehabilitation Center 1656 SOUTH JEFFERSON STREET MONTICELLO, FL 32344 12/4/2008

Jackson [32] 005383 Chipola Health And Rehabilitation Center 4294 3RD AVENUE MARIANNA, FL 32446 12/4/2008

Bay [3] 005384 Glencove Health And Rehabilitation Center 1027 E HWY 98 PANAMA CITY, FL 32401 12/4/2008

Bay [3] 005385 Panama City Health And Rehabilitation Center 924 W 13TH ST PANAMA CITY, FL 32401 12/4/2008

Gadsden [20] 005386 Riverchase Health And Rehabilitation Center 1017 STRONG RD QUINCY, FL 32351 12/4/2008

Suwannee [61] 005387 Suwannee Health And Rehabilitation Center 1620 HELVENSTON ST SE LIVE OAK, FL 32064-3474 12/4/2008

Dade [13] 005388 Berkshire Manor 1255 NE 135TH STREET NORTH MIAMI , FL 33161 12/4/2008 9/1/2014

Brevard [5] 005519 Wave Crest Health and Rehabilitation Center 1415 S HICKORY ST MELBOURNE, FL 32901 12/4/2008

Dade [13] 005523 Fountainhead Care Center 390 NE 135TH ST NORTH MIAMI, FL 33161-3967 12/4/2008 9/1/2014

Volusia [64] 005543 Seaside Health And Rehabilitation Center 324 WILDER BLVD DAYTONA BEACH, FL 32114 12/4/2008

Volusia [64] 005547 Parkside Health And Rehabilitation Center 451 S AMELIA AVE DELAND, FL 32724 12/4/2008

Osceola [49] 005549 Oaks of Kissimmee 320 N MITCHELL ST KISSIMMEE, FL 34741 12/4/2008

Marion [42] 005701 Avante at Ocala 2021 SW 1ST AVE OCALA, FL 34471 11/15/2008

Putnam [54] 005811 Palatka Health Care Center 110 KAY LARKIN DR PALATKA, FL 32177 1/1/2009

Palm Beach [50] 005814 Boynton Health Care Center 7900 VENTURE CENTER WAY BOYNTON BEACH, FL 33437-7402 12/4/2008

Hillsborough [29] 005826 Accentia Health & Rehab. Center of Tampa 1818 E FLETCHER AVE TAMPA, FL 33612-3770 12/4/2008

Pinellas [52] 005849 Glen Oaks Health Care Center 1100 N PINE ST CLEARWATER, FL 33756-4104 12/4/2008

Pasco [51] 005850 Heritage Park 37135 COLEMAN AVE DADE CITY, FL 33525-4526 12/4/2008

Lake [35] 005851 Lake Eustis Care Center 411 W WOODWARD AVE EUSTIS, FL 32726 12/4/2008

Highlands [28] 006339 Lake Placid Health And Rehabilitation Center 125 TOMOKA BLVD S LAKE PLACID, FL 33852-8123 12/4/2008

Bradford [4] 006340 Windsor Health And Rehabilitation Center 602 E LAURA ST STARKE, FL 32091 12/4/2008

Martin [43] 006483 Salerno Bay Health And Rehabilitation Center 4801 SE COVE RD STUART, FL 34997-1602 12/4/2008

Palm Beach [50] 006489 Royal Palm Beach Health And Rehabilitation Center 600 BUSINESS PARK WAY ROYAL PALM BEACH, FL 33411-1747 12/4/2008

Hendry [26] 006767 Oakbrook Health And Rehabilitation Center 250 BROWARD AVE LABELLE, FL 33935 12/4/2008

Manatee [41] 008793 Woods of Manatee Springs 5627 9TH ST E BRADENTON, FL 34203 7/1/2007

Palm Beach [50] 010082 Courtyard Gardens Rehabilitation Center 17781 THELMA AVENUE JUPITER, FL 33458 6/1/2009

Sarasota [58] 010453 Heartland Health Care & Rehabilitation Center 5401 SAWYER RD SARASOTA, FL 34233 7/10/2009

Palm Beach [50] 011997 Heartland Health Care And Rehabilitation Center Of Boca Raton 7225 BOCA DEL MAR DRIVE BOCA RATON, FL 33433 8/5/2009

Indian River [31] 011998 Grace Rehabilitation Center Of Vero Beach 2180 10TH AVENUE VERO BEACH, FL 32960 3/7/2009

Pinellas [52] 014169 Gulf Shore Rehab & Nursing 6767 86TH AVE N PINELLAS PARK, FL 33782 7/31/2009

Franklin [19] 015613 St. James Health And Rehabilitation Center 239 CROOKED RIVER ROAD CARRABELLE, FL 32322 5/26/2009

Escambia [17] 017221 Bayside Health And Rehabilitation Center 4343 LANGLEY AVENUE PENSACOLA , FL 32504 1/1/2010

Broward [6] 017222 Margate Health And Rehabilitation Center 5951 COLONIAL DRIVE MARGATE , FL 33063 1/1/2010

Escambia [17] 017223 Rosewood Healthcare And Rehabilitation Center 3107 NORTH H STREET PENSACOLA, FL 32501-1043 1/1/2010

Santa Rosa [57] 017225 Bay Breeze Senior Living And Rehabilitation Center 3387 GULF BREEZE PARKWAY GULF BREEZE, FL 32563 1/1/2010

Okaloosa [46] 017230 Silvercrest Health And Rehabilitation Center 910 BROOKMEADE DRIVE CRESTVIEW, FL 32539 1/1/2010

Escambia [17] 017236 Specialty Health And Rehabilitation Center 6984 PINE FOREST ROAD PENSACOLA, FL 32526 1/1/2010

Walton [66] 017242 Grand Boulevard Health & Rehab. Center 138 SANDESTIN LANE MIRAMAR BEACH, FL 32550 1/1/2010

Orange [48] 017301 Lake Bennett Health and Rehabilitation 1091 KELTON AVE OCOEE, FL 34761 1/1/2010

Broward [6] 018066 The Park Summit at Coral Springs 8500 ROYAL PALM BLVD CORAL SPRINGS, FL 33065 1/1/2010

(2)

AHCA

County Medicaid Number Provider Name Address Line1 City State Zip Date Active Date Inactive

Sarasota [58] 018777 Bay Village of Sarasota 8400 VAMO ROAD SARASOTA, FL 34231 2/22/2010

Pinellas [52] 019085 Golfview Healthcare Center 3636 10TH AVE N SAINT PETERSBURG, FL 33713 4/1/2010

Pasco [51] 019282 Southern Pines Healthcare Center 6140 CONGRESS ST NEW PORT RICHEY, FL 34653 4/1/2010

Duval [16] 019284 Signature HealthCARE of Jacksonville 2061 HYDE PARK RD JACKSONVILLE, FL 32210 4/1/2010

Broward [6] 019287 Golfcrest Healthcare Center 600 NORTH 17TH AVE HOLLYWOOD, FL 33020 4/1/2010

Volusia [64] 021261 Coastal Health and Rehabilitation Center 820 N CLYDE MORRIS BLVD DAYTONA BEACH, FL 32117 1/10/2010

Volusia [64] 022138 Carlton Shores Health and Rehab Center 1350 S NOVA RD DAYTONA BEACH, FL 32114 5/1/2010

Calhoun [7] 022987 Blountstown Health and Rehabilitation Center 16690 SW CHIPOLA RD BLOUNTSTOWN, FL 32424 4/1/2011

Hillsborough [29] 022994 The Home Association, Inc. 1203 E 22ND AVE TAMPA, FL 33605 3/1/2009

Okeechobee [47] 023067 Okeechobee Healthcare Facility 1646 HIGHWAY 441 N OKEECHOBEE, FL 34972 4/1/2009

Polk [53] 023255 Astoria Health and Rehabilitation Center 701 OVERLOOK DR SE WINTER HAVEN, FL 33884-1671 11/4/2010 12/1/2012

Monroe [44] 024167 Key West Health & Rehabilitation 5860 W JUNIOR COLLEGE RD KEY WEST, FL 33040 8/12/2010

Broward [6] 026536 West Broward Rehabilitation and Healthcare 7751 W BROWARD BLVD PLANTATION, FL 33324 6/1/2010

Palm Beach [50] 028100 The Crossings 4445 PINE FOREST DRIVE LAKE WORTH , FL 33463 6/30/2010 12/30/2013

Broward [6] 028133 Cross Pointe Care Center 440 PHIPPEN WAITERS ROAD DANIA BEACH, FL 33004 6/30/2010 12/30/2013

Pinellas [52] 028148 Cross Terrace Rehabilitation Center 1351 SAN CHRISTOPHER DR DUNEDIN, FL 34698 6/30/2010 12/30/2013

Brevard [5] 028602 Wuesthoff Progressive Care Center 8050 SPYGLASS HILL RD VIERA, FL 32940 10/1/2010 6/1/2014

Orange [48] 030479 The Health Center of Windermere 4875 CASON COVE DRIVE ORLANDO, FL 32811 1/1/2011

Hillsborough [29] 030484 The Health Center of Plant City 701 N WILDER RD PLANT CITY, FL 33566-7547 1/1/2011

Escambia [17] 030487 The Health Center of Pensacola 8475 UNIVERSITY PARKWAY PENSACOLA, FL 32514 1/1/2011

Martin [43] 030490 Parkway Health & Rehab 800 SE CENTRAL PKWY STUART, FL 34994 1/1/2011

Brevard [5] 030491 The Health Center of Merritt Island 500 CROCKETT BLVD MERRITT ISLAND, FL 32953 1/1/2011

Columbia [12] 030527 The Health Center of Lake City 560 SW MCFARLANE AVE LAKE CITY, FL 32025 1/1/2011

Collier [11] 030530 Imperial Health Care Center 900 IMPERIAL GOLF COURSE BLVD NAPLES, FL 34110 1/1/2011

Volusia [64] 030535 The Health Center of Daytona Beach 550 NATIONAL HEALTHCARE DRIVE DAYTONA BEACH, FL 32114 1/1/2011

Broward [6] 030537 Health Center of Coconut Creek 4125 WEST SAMPLE RD COCONUT CREEK, FL 33073 1/1/2011

Charlotte [8] 030540 Charlotte Harbor Healthcare 4000 KINGS HWY PORT CHARLOTTE, FL 33980 1/1/2011

Pasco [51] 030546 Bayonet Point Health & Rehabilitation Center 7210 BEACON WOODS DR HUDSON, FL 34667-1974 1/1/2011

Collier [11] 030552 The Aristocrat 10949 PARNU STREET NAPLES, FL 34109 1/1/2011

Lake [35] 031880 North Campus Rehabilitation and Health Center 700 N PALMETTO ST LEESBURG, FL 34748 4/1/2011 2/1/2014

St Johns [55] 032049 Clyde E. Lassen State Veterans' Nursing Home 4650 STATE RD 16 SAINT AUGUSTINE, FL 32092 11/16/2010

Dade [13] 032482 Unity Health and Rehab Center 1404 NW 22ND STREET MIAMI, FL 33142 5/13/2011

Lake [35] 032486 Lady Lake Specialty Care Center 630 GRIFFIN AVENUE LADY LAKE, FL 32159 5/13/2011

Sarasota [58] 032551 Sunset Lake Health and Rehab Center 832 SUNSET LAKE BOULEVARD VENICE, FL 34292 5/13/2011

Pinellas [52] 032553 Lexington Health & Rehabilitation Center 6300 46TH AVE N SAINT PETERSBURG, FL 33709 5/13/2011

Leon [37] 033175 Seven Hills Health & Rehab Center 3333 CAPITAL MEDICAL BLVD TALLAHASSEE, FL 32308 12/1/2010

Sarasota [58] 033717 Benderson Family Skilled Nursing & Rehab Center 1959 N HONORE AVE SARASOTA, FL 34235 3/22/2011

Polk [53] 034504 Grace Healthcare of Lake Wales 730 N SCENIC HWY LAKE WALES, FL 33853-3208 3/9/2011

Palm Beach [50] 038640 NuVista Living at Wellington Green 10330 NuVISTA AVENUE WELLINGTON, FL 33414 10/4/2011

Hillsborough [29] 041324 NuVista Living at Hillsborough Lakes 19091 N DALE MABRY HWY LUTZ, FL 33548 9/28/2011

Volusia [64] 041685 University Center West 545 WEST EUCLID AVENUE DELAND, FL 32720 4/1/2009

Volusia [64] 041686 University Center East 991 E NEW YORK AVE DELAND, FL 32724 4/1/2009

Jefferson [33] 042138 Cross Landings Health and Rehab 1780 N JEFFERSON ST MONTICELLO, FL 32344 6/28/2011 12/30/2013

Madison [40] 042140 Crosswinds Health and Rehab 13455 W US HWY 90 GREENVILLE, FL 32331 6/28/2011 12/30/2013

Hernando [27] 043832 Heron Pointe Health and Rehabilitation 1445 HOWELL AVE BROOKSVILLE, FL 34601 2/1/2012

Leon [37] 043833 Heritage Healthcare Center At Tallahassee 3101 GINGER DRIVE TALLAHASSEE, FL 32308 2/1/2012

Sarasota [58] 043835 Bay Breeze Health And Rehabilitation Center 1026 ALBEE FARM RD VENICE, FL 34285 2/1/2012

Collier [11] 043838 Heritage Healthcare and Rehabilitation Center 777 9TH ST N NAPLES, FL 34102 2/1/2012

Osceola [49] 043839 Keystone Rehabilitation and Health Center 1120 WEST DONEGAN AVENUE KISSIMMEE, FL 34741 2/1/2012

(3)

AHCA

County Medicaid Number Provider Name Address Line1 City State Zip Date Active Date Inactive

Volusia [64] 043843 Oaktree Healthcare 650 REED CANAL ROAD SOUTH DAYTONA , FL 32119 2/1/2012

Orange [48] 043846 Rio Pinar Health Care 7950 LAKE UNDERHILL ROAD ORLANDO, FL 32822 2/1/2012

Brevard [5] 043847 The Palms Rehabilitation and Healthcare Center 5405 BABCOCK ST NE PALM BAY, FL 32905 2/1/2012

Lee [36] 043848 Coral Trace Health Care 216 SANTA BARBARA BLVD CAPE CORAL, FL 33991 2/1/2012

Orange [48] 043850 The Parks Healthcare and Rehabilitation Center 9311 S ORANGE BLOSSOM TRAIL ORLANDO, FL 32837 2/1/2012

Palm Beach [50] 043851 Coral Bay Healthcare and Rehabilitation 2939 SOUTH HAVERHILL ROAD WEST PALM BEACH , FL 33415 2/1/2012

Osceola [49] 043853 Plantation Bay Rehabilitation Center 4641 OLD CANOE CREEK ROAD SAINT CLOUD, FL 34769 2/1/2012

Orange [48] 043854 Colonial Lakes Health Care 15204 W COLONIAL DR WINTER GARDEN, FL 34787 2/1/2012

Hillsborough [29] 043856 Central Park Healthcare and Rehabilitation Center 702 S KINGS AVE BRANDON, FL 33511 2/1/2012

Sarasota [58] 043857 Beneva Lakes Healthcare and Rehabilitation Center 741 SOUTH BENEVA ROAD SARASOTA, FL 34232 2/1/2012

Manatee [41] 043859 Bradenton Health Care 6305 CORTEZ RD W BRADENTON, FL 34210 2/1/2012

Hillsborough [29] 043860 Brandon Health and Rehabilitation Center 1465 OAKFIELD DR BRANDON, FL 33511 2/1/2012

St Lucie [56] 043861 Fort Pierce Health Care 611 S 13TH STREET FORT PIERCE, FL 34950-4054 2/1/2012

Hillsborough [29] 043862 Habana Health Care Center 2916 HABANA WAY TAMPA , FL 33614 2/1/2012

Pinellas [52] 043863 The Health and Rehabilitation Centre at Dolphins View 1820 SHORE DR S SOUTH PASADENA, FL 33707 2/1/2012

Flagler [18] 043864 Grand Oaks Health and Rehabilitation Center 3001 PALM COAST PARKWAY SE PALM COAST , FL 32137 2/1/2012

Duval [16] 043865 Harts Harbor Health Care Center 11565 HARTS ROAD JACKSONVILLE , FL 32218 2/1/2012

Hillsborough [29] 043866 Fletcher Health and Rehabilitation Center 518 W FLETCHER AVE TAMPA, FL 33612 2/1/2012

Polk [53] 043867 Wedgewood Healthcare Center 1010 CARPENTERS WAY LAKELAND, FL 33809 2/1/2012

Volusia [64] 043868 Deltona Health Care 1851 ELKCAM BLVD DELTONA, FL 32725 2/1/2012

Seminole [59] 043871 Lake Mary Health and Rehabilitation Center 710 NORTH SUN DRIVE LAKE MARY, FL 32746 2/1/2012

Pinellas [52] 043872 Countryside Rehab and Healthcare Center 3825 COUNTRYSIDE BLVD N PALM HARBOR, FL 34684 2/1/2012

Broward [6] 043873 Harbor Beach Nursing and Rehabilitation Center 1615 MIAMI ROAD FORT LAUDERDALE, FL 33316 2/1/2012

Citrus [9] 043874 Health Center at Brentwood 2333 N BRENTWOOD CIR LECANTO, FL 34461 2/1/2012

Clay [10] 043875 Governor's Creek Health and Rehabilitation 803 OAK ST GREEN COVE SPRINGS, FL 32043 2/1/2012

Pinellas [52] 043876 Largo Health And Rehabilitation Center 9035 BRYAN DAIRY RD LARGO, FL 33777 2/1/2012

Sarasota [58] 043877 Magnolia Health and Rehabilitation Center 1507 SOUTH TUTTLE AVENUE SARASOTA, FL 34239 2/1/2012

Taylor [62] 043878 Marshall Health and Rehabilitation Center 207 MARSHALL DRIVE PERRY, FL 32347 2/1/2012

Alachua [1] 043880 North Florida Rehabilitation and Specialty Care 6700 NW 10TH PLACE GAINESVILLE, FL 32605 2/1/2012

Okaloosa [46] 044886 Crestview Rehabilitation Center 1849 FIRST AVENUE EAST CRESTVIEW , FL 32539 2/1/2012

Okaloosa [46] 044888 Fort Walton Rehabilitation Center 1 LBJ SR DRIVE FORT WALTON BEACH, FL 32548 2/1/2012

Calhoun [7] 044889 River Valley Rehabilitation Center 17884 NE CROZIER ST BLOUNTSTOWN, FL 32424 2/1/2012

Monroe [44] 044975 Plantation Key Nursing Center 48 HIGH POINT ROAD TAVERNIER, FL 33070 12/19/2011

Polk [53] 045471 The Crossroads 206 W ORANGE ST DAVENPORT, FL 33837 6/30/2010 12/30/2013

Dade [13] 046017 Homestead Manor A Palace Community 1330 NW 1ST AVE HOMESTEAD, FL 33030 11/1/2011

Dade [13] 046128 Victoria Nursing and Rehabilitation Center, Inc. 955 NW 3RD ST MIAMI, FL 33128 8/19/2011

Sarasota [58] 046233 Crossbreeze Care Center 1755 18TH ST SARASOTA, FL 34234 10/1/2011

Dade [13] 046758 Riverside Care Center 899 NW 4TH STREET MIAMI, FL 33128 3/29/2012

Palm Beach [50] 047787 Renaissance Health and Rehabilitation 5065 WALLIS ROAD WEST PALM BEACH , FL 33415 2/1/2012

Palm Beach [50] 047788 Wood Lake Nursing and Rehabilitation Center 6414 13TH ROAD SOUTH WEST PALM BEACH , FL 33415 2/1/2012 Broward [6] 047795 Hillcrest Health Care And Rehabilitation Center 4200 WASHINGTON STREET HOLLYWOOD , FL 33021 2/1/2012

Orange [48] 048441 Health Central Park 411 NORTH DILLARD STREET WINTER GARDEN, FL 34787 4/1/2012

Marion [42] 048611 Ocala Oaks Rehabilitation Center 3930 E SILVER SPRINGS BLVD OCALA, FL 34470-5006 6/1/2012

Dade [13] 048807 Riviera Health Resort 6901 YUMURI STREET CORAL GABLES, FL 33146 6/14/2012

Dade [13] 054789 South Dade Nursing and Rehabilitation Center 17475 S DIXIE HWY MIAMI, FL 33157 6/1/2012

Dade [13] 054790 Golden Glades Nursing and Rehabilitation Center 220 SIERRA DRIVE MIAMI , FL 33179 6/1/2012

Lee [36] 059369 Calusa Harbour 2525 FIRST ST FORT MYERS, FL 33901 10/1/2012

Pinellas [52] 059400 Stratford Court of Palm Harbor 45 KATHERINE BLVD PALM HARBOR, FL 34684 10/1/2012

St Lucie [56] 059404 Gardens of Port St. Lucie 1699 SE LYNGATE DRIVE PORT SAINT LUCIE, FL 34952 10/1/2012

(4)

AHCA

County Medicaid Number Provider Name Address Line1 City State Zip Date Active Date Inactive

Okaloosa [46] 059852 Shoal Creek Rehabilitation Center 500 HOSPITAL DRIVE CRESTVIEW, FL 32539 2/1/2012

Charlotte [8] 059855 Englewood Healthcare & Rehabilitation Center 1111 DRURY LANE ENGLEWOOD, FL 34224 2/1/2012

Brevard [5] 059866 Island Health and Rehabilitation Center 125 ALMA BLVD MERRITT ISLAND, FL 32953 2/1/2012

Orange [48] 059869 Rosewood Health and Rehabilitation Center 3920 ROSEWOOD WAY ORLANDO, FL 32808 2/1/2012

Lee [36] 059873 Evans Health Care 3735 EVANS AVE FORT MYERS, FL 33901 2/1/2012

Bay [3] 059874 Sea Breeze Health Care 1937 JENKS AVE PANAMA CITY, FL 32405 2/1/2012

Hernando [27] 059877 Spring Hill Health and Rehabilitation Center 12170 CORTEZ BLVD BROOKSVILLE, FL 34613 2/1/2012

Bay [3] 060972 Emerald Shores Health and Rehabilitation 626 NORTH TYNDALL PARKWAY CALLAWAY, FL 32404 2/1/2012

Escambia [17] 060993 University Hills Health and Rehabilitation 10040 HILLVIEW ROAD PENSACOLA, FL 32514 2/1/2012

Lee [36] 061095 Heritage Park Rehabilitation and Healthcare 2826 CLEVELAND AVE FORT MYERS, FL 33901 2/1/2012

Okaloosa [46] 061101 Destin Healthcare and Rehabilitation Center 195 MATTIE M KELLY BLVD DESTIN, FL 32541 2/1/2012

Duval [16] 061102 San Jose Health and Rehabilitation Center 9355 SAN JOSE BLVD JACKSONVILLE, FL 32257 2/1/2012

Broward [6] 061107 SeaView Nursing and Rehabilitation Center 2401 NE 2ND STREET POMPANO BEACH, FL 33062 2/1/2012

Brevard [5] 061109 Vista Manor 1550 JESS PARRISH CT TITUSVILLE, FL 32796 2/1/2012

Pinellas [52] 061140 Lakeside Oaks Care Center 1061 VIRGINIA ST DUNEDIN, FL 34698 2/1/2012

Palm Beach [50] 071884 Whitehall Boca Raton 7300 DEL PRADO CIRCLE SOUTH BOCA RATON, FL 33433 1/1/2013 8/2/2013

Lake [35] 072048 South Campus Rehabilitation & Nursing Center 715 E DIXIE AVE LEESBURG, FL 34748 12/28/2012

Pinellas [52] 072054 Rehabilitation Center of St. Pete 435 42ND AVE S SAINT PETERSBURG, FL 33705 1/1/2013

Marion [42] 072320 The Club Health and Rehab Center at the Villages 16529 SE 86TH BELLE MEADE CIRCLE THE VILLAGES, FL 32162-5885 7/13/2012

Manatee [41] 073324 Braden River Rehabilitation Center, LLC 2010 MANATEE AVE E BRADENTON, FL 34208-1560 1/1/2013

Polk [53] 080062 The Groves Center 512 S 11TH ST LAKE WALES, FL 33853-4901 4/1/2009

Polk [53] 080068 Lakeland Hills Center 610 E BELLA VISTA DR LAKELAND, FL 33805 4/1/2009

Pinellas [52] 080079 Tarpon Bayou Center 515 CHESAPEAKE DR TARPON SPRINGS, FL 34689 4/1/2009

Pasco [51] 080374 Consulate Health Care of Bayonet Point 8132 HUDSON AVENUE HUDSON, FL 34667-8571 10/1/2012

Hillsborough [29] 080377 Consulate Health Care of Brandon 701 VICTORIA ST BRANDON, FL 33510-4100 10/1/2012

Duval [16] 080384 Consulate Health Care of Jacksonville 4101 SOUTHPOINT DRIVE EAST JACKSONVILLE , FL 32216 10/1/2012

Osceola [49] 080387 Consulate Health Care of Kissimmee 2511 JOHN YOUNG PARKWAY NORTH KISSIMMEE, FL 34741 10/1/2012

Polk [53] 080391 Consulate Health Care of Lakeland 5245 N SOCRUM LOOP RD LAKELAND, FL 33809 10/1/2012

Polk [53] 080393 Consulate Health Care of Lake Parker 2020 W LAKE PARKER DR LAKELAND, FL 33805-5005 10/1/2012

Brevard [5] 080394 Consulate Health Care of Melbourne 3033 SARNO RD MELBOURNE, FL 32934 10/1/2012

Pasco [51] 080397 Consulate Health Care of New Port Richey 8417 OLD COUNTY RD 54 NEW PORT RICHEY, FL 34653 10/1/2012

Lee [36] 080400 Consulate Health Care of North Ft. Myers 991 PONDELLA RD NORTH FORT MYERS, FL 33903 10/1/2012

Clay [10] 080402 Consulate Health Care of Orange Park 1215 KINGSLEY AVE ORANGE PARK, FL 32073 10/1/2012

Escambia [17] 080405 Consulate Health Care of Pensacola 235 WEST AIRPORT BLVD PENSACOLA , FL 32505 10/1/2012

Pinellas [52] 080406 Consulate Health Care of Safety Harbor 1410 DR MARTIN LUTHER KING JR ST N SAFETY HARBOR, FL 34695-3303 10/1/2012

Pinellas [52] 080409 Consulate Health Care of St. Petersburg 9393 PARK BLVD SEMINOLE, FL 33777-4140 10/1/2012

Sarasota [58] 080413 Consulate Health Care of Sarasota 4783 FRUITVILLE ROAD SARASOTA, FL 34232 10/1/2012

Charlotte [8] 080416 Consulate Health Care of Port Charlotte 18480 COCHRAN BLVD PORT CHARLOTTE, FL 33948 10/1/2012

Leon [37] 080428 Consulate Health Care of Tallahassee 1650 PHILLIPS RD TALLAHASSEE , FL 32308 10/1/2012

Indian River [31] 080430 Consulate Health Care of Vero Beach 1310 37TH ST VERO BEACH, FL 32960-4860 10/1/2012

Seminole [59] 080431 Consulate Health Care at West Altamonte 1099 WEST TOWN PARKWAY ALTAMONTE SPRINGS, FL 32714 10/1/2012

Palm Beach [50] 080432 Consulate Health Care of West Palm Beach 1626 DAVIS RD WEST PALM BCH, FL 33406-5640 10/1/2012

Polk [53] 080434 Consulate Health Care of Winter Haven 2701 LAKE ALFRED RD WINTER HAVEN, FL 33881 10/1/2012

Dade [13] 080436 Franco Nursing and Rehabilitation Center 800 NW 95TH STREET MIAMI , FL 33150 10/1/2012

Lake [35] 081046 The Villages Rehabilitation and Nursing Center 900 HIGHWAY 466 LADY LAKE, FL 32159 3/11/2013

Dade [13] 082204 University Plaza Rehabilitation & Nursing Center 724 NW 19TH ST MIAMI, FL 33136 8/22/2013

Sarasota [58] 085643 Sarasota Point Rehabilitation Center 2600 COURTLAND STREET SARASOTA, FL 34237 10/24/2013

Duval [16] 086990 Bartram Crossing 6209 BROOKS BARTRAM DRIVE JACKSONVILLE, FL 32258 7/9/2013

Dade [13] 088049 Cross Gardens Care Center 190 NE 191ST STREET MIAMI , FL 33179 10/11/2012

(5)

AHCA

County Medicaid Number Provider Name Address Line1 City State Zip Date Active Date Inactive

Dade [13] 089220 Watercrest Care Center 16650 W DIXIE HWY NORTH MIAMI BEACH, FL 33160 5/1/2013

Sumter [60] 092678 Osprey Point Nursing Center 1104 NORTH MAIN STREET BUSHNELL, FL 33513-5045 8/1/2013

Columbia [12] 092681 Baya Pointe Nursing and Rehabilitation Center 587 SE ERMINE AVE LAKE CITY, FL 32025 8/1/2013

Sarasota [58] 094353 Hawthorne Health and Rehab of Sarasota 5381 Desoto Road SARASOTA, FL 34235 1/15/2013

Escambia [17] 096150 Willowbrooke Court at Azalea Trace 10100 HILLVIEW DR PENSACOLA, FL 32514 8/1/2012

Dade [13] 098577 Palm Garden of Aventura 21251 E DIXIE HIGHWAY NORTH MIAMI BEACH , FL 33180 11/1/2013

Pinellas [52] 098580 Palm Garden of Clearwater 3480 MCMULLEN BOOTH RD CLEARWATER, FL 33761 11/1/2013

Alachua [1] 098581 Palm Garden of Gainesville 227 SW 62ND BLVD GAINESVILLE, FL 32607 11/1/2013

Duval [16] 098582 Palm Garden of Jacksonville 5725 SPRING PARK ROAD JACKSONVILLE , FL 32216 11/1/2013

Pinellas [52] 098583 Palm Garden of Largo 10500 STARKEY RD LARGO, FL 33777 11/1/2013

Marion [42] 098584 Palm Garden of Ocala 2700 SW 34TH ST OCALA, FL 34474 11/1/2013

Orange [48] 098586 Palm Garden of Orlando 654 N ECONLOCKHATCHEE TRAIL ORLANDO, FL 32825-6402 11/1/2013

Pinellas [52] 098587 Palm Garden of Pinellas 200 16TH AVE SE LARGO, FL 33771 11/1/2013

St Lucie [56] 098588 Palm Garden of Port Saint Lucie 1751 SE HILLMOOR DRIVE PORT SAINT LUCIE, FL 34952 11/1/2013

Hillsborough [29] 098589 Palm Garden of Sun City 3850 UPPER CREEK DR SUN CITY CENTER, FL 33573 11/1/2013

Hillsborough [29] 098590 Palm Garden of Tampa 3612 E 138TH AVE TAMPA, FL 33613 11/1/2013

Indian River [31] 098591 Palm Garden of Vero Beach 1755 37TH STREET VERO BEACH , FL 32960 11/1/2013

Palm Beach [50] 098592 Palm Garden of West Palm Beach 300 EXECUTIVE CENTER DRIVE WEST PALM BEACH , FL 33401 11/1/2013

Polk [53] 098593 Palm Garden of Winter Haven 1120 CYPRESS GARDENS BLVD WINTER HAVEN, FL 33884 11/1/2013

Bay [3] 098972 Community Health and Rehabilitation Center 3611 TRANSMITTER ROAD PANAMA CITY, FL 32404-9799 1/1/2014

Pinellas [52] 099366 Gulfport Rehabilitation Center 1430 PASADENA AVE S SOUTH PASADENA, FL 33707 11/24/2013

Osceola [49] 100487 The Terrace of Kissimmee 221 PARK PLACE BLVD KISSIMMEE, FL 34741 12/1/2013

Escambia [17] 100509 Arcadia Health & Rehabilitation Center 10095 HILLVIEW ROAD PENSACOLA, FL 32514 12/1/2013

Pinellas [52] 101391 The Oaks of Clearwater 420 BAY AVE CLEARWATER, FL 33756 1/17/2014

Pinellas [52] 101959 Carrington Place of St. Pete 10501 ROOSEVELT BLVD N SAINT PETERSBURG, FL 33716 4/30/2013

Pasco [51] 101961 Trinity Regional Rehab Center 2144 WELBILT BLVD TRINITY, FL 34655 4/30/2013

Pinellas [52] 101963 Eagle Lake Rehab & Care Center 1100 66TH ST N ST PETERSBURG, FL 33710-6224 4/30/2013

Osceola [49] 102419 The Terrace of St. Cloud 3855 OLD CANOE CREEK ROAD SAINT CLOUD, FL 34769 12/1/2013

Polk [53] 102586 The Crossroads 206 W ORANGE ST DAVENPORT, FL 33837 12/30/2013

Palm Beach [50] 102592 The Crossings 4445 PINE FOREST DRIVE LAKE WORTH , FL 33463 12/30/2013

Broward [6] 102787 Cross Pointe Care Center 440 PHIPPEN WAITERS ROAD DANIA BEACH, FL 33004 12/30/2013

Pinellas [52] 102791 Cross Terrace Rehabilitation Center 1351 SAN CHRISTOPHER DR DUNEDIN, FL 34698 12/30/2013

Jefferson [33] 102832 Cross Landings Health and Rehabilitation Center 1780 N JEFFERSON ST MONTICELLO, FL 32344 12/30/2013

Madison [40] 102833 Crosswinds Health and Rehabilitation Center 13455 W US HWY 90 GREENVILLE, FL 32331 12/30/2013

Polk [53] 103165 Astoria Health & Rehabilitation Center 701 OVERLOOK DR SE WINTER HAVEN, FL 33884-1671 12/1/2012

Desoto [14] 103177 Desoto Health and Rehab 475 NURSING HOME DR ARCADIA, FL 34266 12/31/2013

Hillsborough [29] 103425 Community Convalescent Center 2202 W OAK AVE PLANT CITY, FL 33563 3/1/2013

Okaloosa [46] 103475 Westwood Nursing & Rehabilitation Center 1001 MAR-WALT DRIVE FORT WALTON BEACH, FL 32547 12/5/2013

Orange [48] 103852 Ocoee Health Care Center 1556 MAGUIRE RD OCOEE, FL 34761 3/1/2014

Lake [35] 103858 North Campus Rehabilitation and Nursing Center 700 N PALMETTO ST LEESBURG, FL 34748 2/1/2014

Escambia [17] 104875 Rehabilitation Center at Park Place 1717 W AVERY ST PENSACOLA, FL 32501 4/1/2014

Duval [16] 108507 The Terrace of Jacksonville 10680 OLD ST AUGUSTINE RD JACKSONVILLE, FL 32257 5/1/2014

Brevard [5] 110482 Viera Health & Rehabilitation Center 8050 SPYGLASS HILL RD VIERA, FL 32940 6/1/2014

Duval [16] 111543 St. Catherine Laboure Manor, Inc. 1750 STOCKTON ST JACKSONVILLE, FL 32204 7/1/2014

Manatee [41] 116763 Riverfront Nursing and Rehabilitation Center 105 15TH ST E BRADENTON, FL 34208 5/11/2014

Duval [16] 122242 Cypress Village 4600 MIDDLETON PARK CIR E JACKSONVILLE, FL 32224 8/29/2014

Lake [35] 122243 Lake Harris Health Center 701 LAKE PORT BLVD LEESBURG, FL 34748 8/29/2014

Pinellas [52] 122248 Sylvan Health Center 2770 REGENCY OAKS BLVD CLEARWATER , FL 33759 8/29/2014

Citrus [9] 122340 Citrus Hills Health & Rehabilitation Center 124 W NORVELL BRYANT HWY HERNANDO, FL 34442 7/1/2014

(6)

AHCA

County Medicaid Number Provider Name Address Line1 City State Zip Date Active Date Inactive

Volusia [64] 122342 The Gardens Health & Rehabilitation Center 1704 HUNTINGTON VILLAGE CIRCLE DAYTONA BEACH , FL 32114 7/1/2014

Clay [10] 122343 Isle Health & Rehabilitation Center 1125 FLEMING PLANTATION BLVD ORANGE PARK, FL 32003 7/1/2014

Bradford [4] 122344 Riverwood Health & Rehabilitation Center 808 S COLLEY RD STARKE, FL 32091 7/1/2014

Alachua [1] 122346 Terrace Health & Rehabilitation Center 7207 SW 24TH AVE GAINESVILLE, FL 32607 7/1/2014

Volusia [64] 122347 Villa Health & Rehabilitation Center 120 CHIPOLA AVE DELAND, FL 32720 7/1/2014

Bay [3] 128848 Bay Center 1336 ST ANDREWS BLVD PANAMA CITY, FL 32405 4/1/2009

Clay [10] 129312 The Pavilion for Health Care ONE PAVILION PLACE PENNEY FARMS, FL 32079 8/15/2014

Clay [10] 130817 Oak View Rehabilitation Center 833 KINGSLEY AVE ORANGE PARK, FL 32073 9/1/2014

Dade [13] 132045 North Dade Nursing and Rehabilitation Center 1255 NE 135TH STREET NORTH MIAMI , FL 33161 9/1/2014

Dade [13] 132449 Fountain Manor Health & Rehabilitation Center 390 NE 135TH ST NORTH MIAMI, FL 33161-3967 9/1/2014

Okaloosa [46] 133196 Emerald Coast Center 114 THIRD STREET SE FORT WALTON BEACH, FL 32548 4/1/2009

Pinellas [52] 133348 Egret Cove Center 550 62ND ST S SAINT PETERSBURG, FL 33707 4/1/2009

Broward [6] 134463 Ft Lauderdale Health and Rehabilitation Center 2000 EAST COMMERCIAL BLVD FORT LAUDERDALE, FL 33308 10/1/2014

Pinellas [52] 200107 Bon Secours Maria Manor Nursing Care Center 10300 4TH ST N SAINT PETERSBURG, FL 33716 12/15/1988

Leon [37] 200409 Westminster Oaks 4449 MEANDERING WAY TALLAHASSEE, FL 32308 10/21/1988

Dade [13] 200425 Floridean Nursing And Rehabilitation Center The 47 NW 32ND PLACE MIAMI, FL 33125 1/1/1970

Dade [13] 200506 Miami Jewish Health Systems 5200 NE 2ND AVENUE MIAMI, FL 33137 1/1/1970

Dade [13] 200620 Pines Nursing Home 301 NE 141 STREET MIAMI, FL 33161 1/1/1978

Duval [16] 200735 Cross Care Center 5888 BLANDING BLVD JACKSONVILLE, FL 32244 1/1/1970

Duval [16] 200859 River Garden Hebrew Home For The Aged 11401 OLD SAINT AUGUSTINE RD JACKSONVILLE, FL 32258-1402 1/1/1970

Duval [16] 200913 Avante Villa At Jacksonville Beach Inc 1504 SEABREEZE AVE JACKSONVILLE BEACH, FL 32250 7/1/1989

Pinellas [52] 200956 Comprehensive Healthcare of Clearwater 2055 PALMETTO ST CLEARWATER, FL 33765 12/1/1988

Broward [6] 201006 Memorial Manor 777 SOUTH DOUGLAS ROAD PEMBROKE PINES, FL 33025 7/14/1989

Lee [36] 201120 Gulf Coast Village 1333 SANTA BARBARA BLVD CAPE CORAL, FL 33991 8/28/1989

Martin [43] 201545 Edgewater Manor 9555 SE FEDERAL HWY HOBE SOUND, FL 33455 1/1/1970

Orange [48] 201588 Mary Lee Depugh Nursing Home Association Inc 550 W MORSE BLVD WINTER PARK, FL 32789 1/1/1970

Orange [48] 201651 Guardian Care Nursing & Rehabilitation Center 2500 W CHURCH STREET ORLANDO, FL 32805 1/1/1970

Pinellas [52] 202011 Westchester Gardens Rehabilitation & Care Center 3301 N MCMULLEN BOOTH RD CLEARWATER, FL 33761 1/5/1990

Polk [53] 202533 The Rohr Home 2120 MARSHALL EDWARDS DR BARTOW, FL 33830 10/10/1970

St Johns [55] 202606 Samantha Wilson Care Center 161A MARINE STREET SAINT AUGUSTINE, FL 32084 1/1/1970

Sarasota [58] 202703 Pines of Sarasota 1501 N ORANGE AVE SARASOTA, FL 34236 1/1/1970

Sarasota [58] 202711 Sunnyside Nursing Home 5201 BAHIA VISTA STREET SARASOTA, FL 34232 1/1/1970

Volusia [64] 202789 Center for Health Care of The Alliance Community 130 W ARMSTRONG AVENUE DELAND, FL 32720 8/1/1971

Leon [37] 202941 MIRACLE HILL NURSING AND REHABILITATION CENTERS, INC 1329 ABRAHAM STREET TALLAHASSEE, FL 32304 1/1/1970

Lake [35] 203122 Avante at Leesburg 2000 EDGEWOOD AVE LEESBURG, FL 34748 1/1/1991

Dade [13] 203165 Villa Maria Nursing Center 1050 NE 125TH STREET NORTH MIAMI, FL 33161 1/1/1970

Palm Beach [50] 203203 Glades Health Care Center 230 SOUTH BARFIELD HIGHWAY PAHOKEE, FL 33476 10/15/1990

Citrus [9] 203220 Avante at Inverness 304 S CITRUS AVE INVERNESS, FL 34452 1/1/1991

Palm Beach [50] 203238 Avante at Lake Worth 2501 N A ST LAKE WORTH, FL 33460-6013 1/1/1991

Dade [13] 203327 The Palace at Kendall Nursing and Rehab Center 11215 SW 84TH STREET MIAMI, FL 33173 3/18/1991

Marion [42] 203335 TimberRidge Nursing & Rehab Center 9848 SW 110TH ST OCALA, FL 34481 3/1/1991

Jackson [32] 203475 Marianna Health & Rehabilitation 4295 FIFTH AVENUE MARIANNA, FL 32446 2/1/1971

Polk [53] 203599 The Manor at Carpenter's 1001 CARPENTERS WAY LAKELAND, FL 33809 6/1/1991

Dade [13] 203670 Jackson Memorial Perdue Medical Center 19590 OLD CUTLER ROAD CUTLER RIDGE, FL 33157 9/1/1971

Broward [6] 203769 John Knox Village Of Pompano Beach 830 LAKESIDE CIRCLE POMPANO BEACH, FL 33060 4/1/1972

Manatee [41] 203815 Westminster Towers And Shores Of Bradenton 1533 4TH AVE W BRADENTON, FL 34205 8/1/1991

Bay [3] 203980 Lisenby On Lake Caroline 1400 W 11TH ST PANAMA CITY, FL 32401 10/8/1991

Pinellas [52] 204072 Mease Continuing Care 910 NEW YORK AVE DUNEDIN, FL 34698-6600 1/7/1992

Dade [13] 204161 Jackson Memorial Long Term Care Center 2500 NW 22ND AVE MIAMI, FL 33142 8/1/1973

(7)

AHCA

County Medicaid Number Provider Name Address Line1 City State Zip Date Active Date Inactive

Volusia [64] 204391 Good Samaritan Society-Daytona 325 S SEGRAVE STREET DAYTONA BEACH, FL 32114 1/1/1975

Duval [16] 204536 Fannie E Taylor Home For The Aged Inc 3937 SPRING PARK ROAD JACKSONVILLE, FL 32207 2/1/1976

Gilchrist [21] 204625 Tri-County Nursing Home 7280 SW STATE RD 26 TRENTON, FL 32693 5/18/1992

Duval [16] 205150 St. Catherine Laboure Manor 1750 STOCKTON ST JACKSONVILLE, FL 32204 2/1/1979 7/1/2014

Osceola [49] 205303 Good Samaritan Society-Kissimmee Village 1500 SOUTHGATE DRIVE KISSIMMEE, FL 34746 8/1/1979

Palm Beach [50] 205460 The Village On High Ridge 1800 SOUTH DRIVE LAKE WORTH, FL 33461 12/14/1979

Palm Beach [50] 205745 Abbey Delray 2105 SW 11TH COURT DELRAY BEACH, FL 33445 10/1/1980

Orange [48] 205796 Commons At Orlando Lutheran Towers 210 LAKE AVENUE ORLANDO, FL 32801 10/1/1980

Broward [6] 205800 St. John's Nursing Center 3075 NW 35TH AVE LAUDERDALE LAKES, FL 33311 9/12/1980

Palm Beach [50] 205923 Lourdes-Noreen Mckeen Residence For Geriatric Care, Inc. 315 S FLAGLER DR WEST PALM BEACH, FL 33401 12/1/1980

Hamilton [24] 206300 Suwannee Valley Nursing Center 427 15TH AVENUE NORTHWEST JASPER, FL 32052-5874 7/1/1981

Pinellas [52] 206431 Morton Plant Rehabilitation Center 400 CORBETT ST BELLEAIR, FL 33756 1/1/1983

Palm Beach [50] 206521 Willowbrooke Court At St Andrews Estates 6152 N VERDE TRAIL BOCA RATON, FL 33433 7/1/1986

Palm Beach [50] 206610 The Waterford 601 UNIVERSE BLVD JUNO BEACH, FL 33408 4/1/1982

Palm Beach [50] 206865 Abbey Delray South 1717 HOMEWOOD BLVD DELRAY BEACH, FL 33445 7/15/1982

Palm Beach [50] 207381 Joseph L Morse Geriatric Center Inc 4847 FRED GLADSTONE DRIVE WEST PALM BEACH, FL 33417 7/15/1983

Duval [16] 207446 Taylor Care Center 6535 CHESTER AVENUE JACKSONVILLE, FL 32217 9/22/1983

Broward [6] 207497 Sunrise Health And Rehabilitation Center 4800 N NOB HILL RD SUNRISE, FL 33351-4722 10/7/1983

Polk [53] 207527 Orchard Park Health And Rehabilitation 919 OLD WINTER HAVEN RD AUBURNDALE, FL 33823 10/14/1983

Palm Beach [50] 207683 Lakeside Health Center 2501 N AUSTRALIAN AVENUE WEST PALM BEACH, FL 33407 1/1/1984

St Johns [55] 207799 The Ponce Therapy Care Center 1999 OLD MOULTRIE ROAD SAINT AUGUSTINE, FL 32086 5/8/1984

Pinellas [52] 208442 Bernard L Samson Nursing Center 255 59TH ST N SAINT PETERSBURG, FL 33710 7/1/1985

Palm Beach [50] 208485 Jupiter Medical Center Pavilion Inc. 1230 SOUTH OLD DIXIE HWY JUPITER, FL 33458-7297 9/5/1984

Dade [13] 208507 Claridge House Nursing & Rehabilitation Center 13900 NE 3RD COURT NORTH MIAMI, FL 33161 8/22/1985

Orange [48] 208540 Westminster Towers 70 WEST LUCERNE CIRCLE ORLANDO, FL 32801 7/26/1985

Brevard [5] 209325 Courtenay Springs Village 1100 SOUTH COURTENAY PARKWAY MERRITT ISLAND, FL 32952 11/18/1986

Manatee [41] 209422 Westminster Communities Of Bradenton Westminster Manor 1700 21ST AVE W BRADENTON, FL 34205 3/11/1987

Dade [13] 209473 St. Anne's Nursing Center 11855 QUAIL ROOST DRIVE MIAMI, FL 33177 5/22/1987

Volusia [64] 209511 Bishops Glen Retirement Center 900 LPGA BLVD HOLLY HILL, FL 32117-3100 12/22/1986

Orange [48] 209848 Westminster Winter Park 1111 S LAKEMONT AVE WINTER PARK, FL 32792-5469 10/27/1987

Hillsborough [29] 209856 Sun Terrace Health Care Center 105 TRINITY LAKES DR SUN CITY CENTER, FL 33573 9/1/1987

Seminole [59] 210137 Life Care Center of Altamonte Springs 989 ORIENTA AVE ALTAMONTE SPRINGS, FL 32701 9/1/1988

Broward [6] 210188 Covenant Village Care Center 9211 W BROWARD BLVD PLANTATION, FL 33324 3/15/1988

Hillsborough [29] 210285 John Knox Village Med Center 4100 E FLETCHER AVE TAMPA, FL 33613 12/1/1987

Sarasota [58] 210463 Village on the Isle 910 TAMIAMI TRAIL SOUTH VENICE, FL 34285 5/12/1988

Lee [36] 210587 Healthpark Care Center Inc. 16131 ROSERUSH COURT FORT MYERS, FL 33908-3634 12/18/1992

Palm Beach [50] 210676 Avante At Boca Raton Inc. 1130 NW 15TH STREET BOCA RATON, FL 33486 4/1/1993

Lake [35] 210684 Edgewater At Waterman Village 300 BROOKFIELD AVE MOUNT DORA, FL 32757-9562 5/3/1993

Volusia [64] 210889 Emory L Bennett Memorial Veterans Nursing Home 1920 MASON AVENUE DAYTONA BEACH , FL 32117 1/19/1994

Pinellas [52] 210951 Sabal Palms Health Care Center 499 ALTERNATE KEENE RD NE LARGO, FL 33771 1/7/1994

Palm Beach [50] 211010 Stratford Court Of Boca Raton 6343 VIA DE SONRISA DEL SUR BOCA RATON, FL 33433 3/17/1994

Baker [2] 211052 W Frank Wells Nursing Home 210 N 2ND ST MACCLENNY, FL 32063 10/1/1993

Brevard [5] 211281 Huntington Place 1775 HUNTINGTON LANE ROCKLEDGE, FL 32955 10/1/1994

Hardee [25] 211435 Hardee Manor Healthcare Center 401 ORANGE PLACE WAUCHULA , FL 33873 5/10/1994

St Lucie [56] 211516 Laurel Pointe Health and Rehabilitation 703 South 29th Street FORT PIERCE, FL 34947 12/20/1993

Citrus [9] 211532 Life Care Center of Citrus County 3325 W JERWAYNE LN LECANTO, FL 34461 11/15/1994

Hillsborough [29] 211885 Plaza West 912 AMERICAN EAGLE BLVD SUN CITY CENTER, FL 33573 6/10/1994

Madison [40] 211923 Lake Park of Madison 259 SW CAPTAIN BROWN RD MADISON, FL 32340 8/25/1995

Palm Beach [50] 212032 Edward J Healey Rehabilitation And Nursing Center 5101 WEST BLUE HERON BLVD RIVIERA BEACH, FL 33418 10/1/1995

(8)

AHCA

County Medicaid Number Provider Name Address Line1 City State Zip Date Active Date Inactive

Hillsborough [29] 212164 Ybor City Healthcare and Rehabilitation Center 1709 TALIAFERRO AVE TAMPA, FL 33602 3/1/1996

Palm Beach [50] 212393 The Fountains Nursing Home Inc 3800 N FEDERAL HWY BOCA RATON, FL 33431 1/1/1996

Volusia [64] 212636 Woodland Terrace 120 CHIPOLA AVE DELAND, FL 32720 9/27/1996 7/1/2014

Pinellas [52] 212709 Westminster Suncoast 1095 PINELLAS POINT DR S SAINT PETERSBURG, FL 33705-6272 8/23/1996

Dade [13] 212733 Oceanside Extended Care Center 550 9TH STREET MIAMI BEACH , FL 33139 11/1/1996

Volusia [64] 212792 Good Samaritan Society-Florida Lutheran 450 NORTH MCDONALD AVENUE DELAND, FL 32724 1/17/1997

Dade [13] 212806 Palmetto Sub Acute Care Center Inc 7600 SW 8TH STREET MIAMI, FL 33144 1/24/1997

Pinellas [52] 212890 Egret Cove Center 550 62ND ST S SAINT PETERSBURG, FL 33707 9/1/1996 4/1/2009

Okaloosa [46] 212903 Emerald Coast Center 114 THIRD STREET SE FORT WALTON BEACH, FL 32548 9/1/1996 4/1/2009

Pinellas [52] 212911 Clearwater Center 1270 TURNER ST CLEARWATER, FL 33756 9/1/1996

Polk [53] 212971 Florida Presbyterian Homes Inc 909 LAKESIDE AVE LAKELAND, FL 33803 3/20/1997

Bay [3] 212989 Bay Center 1336 ST ANDREWS BLVD PANAMA CITY, FL 32405 9/1/1996 4/1/2009

Polk [53] 212997 Bartow Center 2055 E GEORGIA ST BARTOW, FL 33830 9/1/1996

Pinellas [52] 213004 Boca Ciega Center 1414 59TH ST S GULFPORT, FL 33707 9/1/1996

Broward [6] 213098 Tamarac Rehabilitation and Health Center 7901 NW 88TH AVENUE TAMARAC, FL 33321 1/1/1997

Martin [43] 213152 Waters Edge Extended Care 1500 SW CAPRI ST PALM CITY, FL 34990 4/23/1997

Clay [10] 213161 Life Care Center at Wells Crossing 355 CROSSING BLVD ORANGE PARK, FL 32073 7/23/1997

Sarasota [58] 213322 Harborchase of Venice 950 PINEBROOK ROAD VENICE, FL 34292 4/1/1997

Orange [48] 213403 Life Care Center of Orlando 3211 ROUSE ROAD ORLANDO, FL 32817 10/2/1997

Madison [40] 213462 Madison Health and Rehabilitation Center 2481 WEST US 90 MADISON, FL 32340-9540 3/1/1998

Palm Beach [50] 213837 Vi at Lakeside Village 2792 DONNELLY DRIVE LANTANA, FL 33462 8/1/1998

Lee [36] 213900 Page Rehabilitation and Healthcare Center 2310 N AIRPORT ROAD FORT MYERS, FL 33907 10/1/1998

Leon [37] 213934 TMH Skilled Nursing Facility 1609 MEDICAL DRIVE TALLAHASSEE , FL 32308 11/16/1998

Dade [13] 214035 MIAMI SHORES NURSING AND REHAB CENTER 9380 NW 7TH AVENUE MIAMI, FL 33150 2/15/1999

Nassau [45] 214060 Life Care Center of Hilliard 3756 W THIRD ST HILLIARD, FL 32046 2/1/1999

Pasco [51] 214914 Baldomero Lopez Memorial Veterans Nursing Home 6919 PARKWAY BLVD LAND O LAKES, FL 34639 5/7/1999

Palm Beach [50] 216399 Harbour's Edge 401 E LINTON BLVD DELRAY BEACH, FL 33483 6/1/1999

Citrus [9] 217263 Crystal River Health And Rehabilitation Center 136 NORTHEAST 12TH AVENUE CRYSTAL RIVER, FL 34429 7/1/1999

Marion [42] 217395 Ocala Health And Rehabilitation Center 1201 SE 24TH RD OCALA, FL 34471 7/1/1999

Brevard [5] 217727 West Melbourne Health & Rehabilitation Center 2125 WEST NEW HAVEN AVE WEST MELBOURNE, FL 32904 7/1/1999

St Johns [55] 217735 St Augustine Health And Rehabilitation Center 51 SUNRISE BLVD SAINT AUGUSTINE, FL 32084 7/1/1999

Volusia [64] 217743 Daytona Beach Health and Rehabilitation Center 1055 3RD STREET DAYTONA BEACH, FL 32117-4196 7/1/1999

St Lucie [56] 217824 Life Care Center Of Port Saint Lucie 3720 SE JENNINGS RD PORT ST LUCIE, FL 34952-7701 9/9/1999

Duval [16] 218171 West Jacksonville Health and Rehabilitation Center 1650 FOURAKER ROAD JACKSONVILLE, FL 32221 3/25/1999

Polk [53] 219380 Life Care Center of Winter Haven 1510 CYPRESS GARDENS BLVD WINTER HAVEN, FL 33884 11/3/1999

Escambia [17] 220604 Century Health And Rehabilitation Center 6020 INDUSTRIAL BLVD CENTURY , FL 32535 2/29/2000

Santa Rosa [57] 220612 Santa Rosa Health & Rehabilitation Center 5386 BROAD ST MILTON, FL 32570-2235 2/29/2000

Santa Rosa [57] 220621 Sandy Ridge Health And Rehabilitation 5360 GLOVER LANE MILTON, FL 32570 2/29/2000

Lake [35] 221465 Clermont Health and Rehabilitation Center 151 E MINNEHAHA AVE CLERMONT, FL 34711 9/29/1999

Orange [48] 221589 Delaney Park Health and Rehabilitation Center 215 ANNIE STREET ORLANDO, FL 32806 9/29/1999

Dade [13] 223239 Regents Park at Aventura 18905 NE 25TH AVE AVENTURA, FL 33180 5/1/2000

Orange [48] 223654 Orlando Health and Rehabilitation Center 830 WEST 29TH STREET ORLANDO, FL 32805 9/29/1999

Manatee [41] 223786 Life Care Center of Sarasota 8104 TUTTLE AVE SARASOTA, FL 34243-2885 6/29/2000

Orange [48] 223808 Avante At Orlando Inc. 2000 NORTH SEMORAN BOULEVARD ORLANDO, FL 32807 6/1/2000

Clay [10] 223883 Doctors Lake of Orange Park 833 KINGSLEY AVE ORANGE PARK, FL 32073 4/1/2000 9/1/2014

Escambia [17] 224243 Pensacola Health Care Facility 1717 W AVERY ST PENSACOLA, FL 32501 1/1/2000 4/1/2014

Polk [53] 224341 Haines City Health Care 409 S 10TH ST HAINES CITY, FL 33845-1476 7/1/2000

Hillsborough [29] 224910 South Tampa Health and Rehabilitation Center 4610 S MANHATTAN AVE TAMPA, FL 33611 1/1/2000

Sarasota [58] 225053 Quality Health Of North Port 6940 OUTREACH WAY NORTH PORT, FL 34287-0947 8/1/2000

(9)

AHCA

County Medicaid Number Provider Name Address Line1 City State Zip Date Active Date Inactive

Orange [48] 225410 Quality Health Of Orange County 12751 W COLONIAL DRIVE WINTER GARDEN, FL 34787 8/1/2000

Broward [6] 225631 Springtree Rehabilitation & Health Care Center 4251 SPRINGTREE DRIVE SUNRISE, FL 33351-6119 6/1/2000

Dade [13] 225754 Pinecrest Rehabilitation Center 13650 NE 3RD COURT NORTH MIAMI, FL 33161 6/1/2000

Martin [43] 225991 Stuart Nursing & Restorative Care Center 1500 SE PALM BEACH RD STUART, FL 34994 1/1/2001

St Lucie [56] 226009 Port St. Lucie Nursing And Restorative Care Center 7300 OLEANDER AVENUE PORT SAINT LUCIE , FL 34952-8299 1/1/2001

Broward [6] 226017 Plantation Nursing & Rehabilitation Center 4250 NW 5TH ST PLANTATION, FL 33317 6/1/2000

Martin [43] 226033 Martin Nursing and Restorative Care Center 6011 SE TOWER DR STUART, FL 34997 11/1/2000

Okaloosa [46] 226041 The Manor at Blue Water Bay 1500 NORTH WHITE POINT ROAD NICEVILLE , FL 32578 1/1/2001

Duval [16] 226068 Cathedral Gerontology Center Inc 333 E ASHLEY ST JACKSONVILLE, FL 32202 5/31/2000

Broward [6] 226335 Broward Nursing & Rehabilitation Center 1330 S ANDREWS AVE FORT LAUDERDALE, FL 33316 6/1/2000

Volusia [64] 226351 Ocean View Nursing & Rehabilitation Center LLC 2810 SOUTH ATLANTIC AVENUE NEW SMYRNA BEACH, FL 32169 6/1/2000 Pinellas [52] 226360 South Heritage Health & Rehabilitation Center 718 LAKEVIEW AVE S SAINT PETERSBURG, FL 33705 1/1/2001

Dade [13] 226602 Treasure Isle Care Center 1735 N TREASURE DRIVE NORTH BAY VILLAGE, FL 33141 1/1/2001

Dade [13] 227226 Fair Havens Center 201 CURTISS PKWY MIAMI SPRINGS, FL 33166-5291 7/24/2000

Pinellas [52] 227251 Alpine Health and Rehabilitation Center 3456 21ST AVE S SAINT PETERSBURG, FL 33711 1/1/2001

Broward [6] 227579 Wilton Manors Health & Rehabilitation Center 2675 N ANDREWS AVE WILTON MANORS, FL 33311 9/20/2000

Brevard [5] 227587 Rockledge Health And Rehabilitation Center 587 BARTON BLVD ROCKLEDGE, FL 32955 9/20/2000

Manatee [41] 227625 Greenbriar Rehabilitation And Nursing Center 210 21ST AVE W BRADENTON, FL 34205 9/20/2000

Pinellas [52] 227633 Apollo Health And Rehabilitation Center 1000 24TH ST N SAINT PETERSBURG, FL 33713 9/20/2000

Pinellas [52] 227641 North Rehabilitation Center 1301 16TH ST N SAINT PETERSBURG, FL 33705 9/20/2000

Alachua [1] 227765 Park Meadows Health And Rehabilitation Center 3250 SW 41ST PLACE GAINESVILLE, FL 32608 9/20/2000

Marion [42] 227773 The Lodge Health and Rehabilitation Center 635 SE 17TH STREET OCALA, FL 34471 9/20/2000

Duval [16] 227838 First Coast Health & Rehabilitation Center 7723 JASPER AVENUE JACKSONVILLE , FL 32211 1/1/2001

Gilchrist [21] 227871 Ayers Health And Rehabilitation Center 606 NE 7TH ST TRENTON, FL 32693 10/1/2000

Dade [13] 228001 North Beach Rehabilitation Center 2201 NE 170TH STREET NORTH MIAMI BEACH, FL 33160 9/20/2000

Palm Beach [50] 228320 The Gardens Court 3803 PGA BOULEVARD PALM BEACH GARDENS, FL 33410 5/1/2001

Brevard [5] 228338 Life Care Center of Melbourne 606 E SHERIDAN RD MELBOURNE, FL 32901 2/28/2001

Duval [16] 228401 Park Ridge Nursing Center 730 COLLEGE STREET JACKSONVILLE, FL 32204 7/16/2001

Pasco [51] 228567 Bear Creek Nursing Center 8041 STATE RD 52 E HUDSON, FL 34667 10/1/2000

Pasco [51] 228575 Royal Oak Nursing Center 37300 ROYAL OAK LANE DADE CITY , FL 33525 10/1/2000

Pasco [51] 228591 Heather Hill Healthcare Center 6630 KENTUCKY AVE NEW PORT RICHEY, FL 34653 10/1/2000

Sarasota [58] 228621 Inn at Sarasota Bay Club 1303 NORTH TAMIAMI TRAIL SARASOTA, FL 34236 6/20/2001

Polk [53] 228702 Winter Haven Health And Rehabilitation Center 202 AVE O NE WINTER HAVEN, FL 33881 1/1/2001

Citrus [9] 228711 Woodland Terrace of Citrus County 124 W NORVELL BRYANT HWY HERNANDO, FL 34442 7/12/2001 7/1/2014

Dade [13] 228788 East Ridge Retirement Village Inc 19301 SW 87TH AVENUE MIAMI, FL 33157 7/12/2001

Citrus [9] 228940 Cypress Cove Care Center 700 SE 8TH AVE CRYSTAL RIVER, FL 34429 10/1/2000

Hernando [27] 228958 Brooksville Healthcare Center 1114 CHATMAN BLVD BROOKSVILLE, FL 34601 10/1/2000

Lake [35] 228966 Lake Harris Health Center 701 LAKE PORT BLVD LEESBURG, FL 34748 9/1/2001 8/29/2014

Pinellas [52] 229164 Sylvan Health Center 2770 REGENCY OAKS BLVD CLEARWATER , FL 33759 9/1/2001 8/29/2014

Lee [36] 229202 Shell Point Nursing Pavilion 15071 SHELL POINT BLVD FORT MYERS, FL 33908 3/28/2001

Alachua [1] 229288 Gainesville Health Care Center 1311 SW 16TH STREET GAINESVILLE, FL 32608 3/7/2001

Palm Beach [50] 229610 Lake View Care Center at Delray 5430 LINTON BLVD DELRAY BEACH, FL 33484 9/20/2001

Palm Beach [50] 229628 Menorah House 9945 CENTRAL PARK BLVD NORTH BOCA RATON, FL 33428 9/20/2001

Broward [6] 229849 Alexander "Sandy" Nininger State Veterans Nursing Home 8401 W CYPRESS DR PEMBROKE PINES, FL 33025 9/6/2001

Dade [13] 250988 HIALEAH SHORES NURSING AND REHAB CENTER 8785 NW 32ND AVENUE MIAMI , FL 33147 2/25/2000

Polk [53] 251399 Brandywyne Health Care Center 1801 N LAKE MARIAM DR WINTER HAVEN, FL 33884 8/1/2000

Pinellas [52] 251666 Concordia Manor 321 13TH AVE N SAINT PETERSBURG, FL 33701 1/1/2001

Marion [42] 251721 Oakhurst Center 1501 SE 24TH RD OCALA, FL 34471-6005 10/1/2001

Bradford [4] 251739 Bradford Terrace 808 S COLLEY RD STARKE, FL 32091 9/1/2001 7/1/2014

(10)

AHCA

County Medicaid Number Provider Name Address Line1 City State Zip Date Active Date Inactive

Volusia [64] 252034 Avante At Ormond Beach Inc 170 N KINGS ROAD ORMOND BEACH, FL 32174 10/1/2000

Lake [35] 252042 Avante At Mt Dora Inc 3050 BROWN AVE MOUNT DORA, FL 32757 10/1/2000

Sarasota [58] 252662 Pinebrook Center 1240 PINEBROOK ROAD VENICE, FL 34285 11/1/2001

Highlands [28] 252671 The Palms of Sebring 725 S PINE ST SEBRING, FL 33870 7/26/2001

Pasco [51] 252689 Orchard Ridge 4927 VOORHEES RD NEW PORT RICHEY, FL 34653 9/1/2001

Sarasota [58] 253014 Springwood Center 4602 NORTHGATE COURT SARASOTA, FL 34234 11/1/2001

Pinellas [52] 253430 Sunset Point 1980 SUNSET POINT RD CLEARWATER, FL 33765-1132 11/1/2001

Pinellas [52] 253448 Bay Tree Center 2600 HIGHLANDS BLVD N PALM HARBOR, FL 34684-2114 11/1/2001

Marion [42] 253456 Hawthorne Health And Rehab Of Ocala 4100 SW 33RD AVE OCALA, FL 34474 12/7/2001

Pinellas [52] 253464 West Bay Of Tampa 3865 TAMPA RD OLDSMAR, FL 34677 11/1/2001

Broward [6] 253481 Forum at Deer Creek 3001 DEER CREEK COUNTRY CLUB DEERFIELD BEACH , FL 33442 1/11/2002

Wakulla [65] 253707 Eden Springs Nursing And Rehab Center 4679 CRAWFORDVILLE HWY CRAWFORDVILLE , FL 32326 8/1/2001

Dade [13] 253723 Jackson Plaza Nursing & Rehabilitation Center 1861 NW 8TH AVENUE MIAMI , FL 33136 1/1/2002

Broward [6] 254177 Manor Pines Convalescent Center 1701 NE 26TH ST WILTON MANORS, FL 33305 3/6/2002

Dade [13] 254291 Arch Plaza Nursing & Rehabilitation Center 12505 NE 16TH AVENUE NORTH MIAMI, FL 33161 1/1/2002

Pinellas [52] 254762 Wrights Healthcare And Rehabilitation Center 11300 110TH AVE N SEMINOLE, FL 33778-3711 5/21/2002

Duval [16] 254878 EdgeWood Nursing Center 1771 EDGEWOOD AVE W JACKSONVILLE, FL 32208 5/16/2002

Alachua [1] 255572 Woodlands Care Center of Alachua County 7207 SW 24TH AVE GAINESVILLE, FL 32607 6/27/2002 7/1/2014

Citrus [9] 256269 Diamond Ridge Health And Rehabilitation Center 2730 W MARC KNIGHTON CT LECANTO, FL 34461 6/1/2002

Manatee [41] 256277 Surrey Place Healthcare and Rehabilitation 5525 21ST AVE W BRADENTON, FL 34209 6/1/2002

Duval [16] 256757 Lakeside Nursing And Rehabilitation Center 11411 ARMSDALE ROAD JACKSONVILLE, FL 32218 9/23/2002

Collier [11] 256846 Lakeside Pavilion 2900 12TH STREET N NAPLES, FL 34103 11/1/2001

Broward [6] 256935 Manor Oaks Nursing & Rehabilitation Center 2121 E COMMERCIAL BLVD FORT LAUDERDALE, FL 33308 12/1/2002

Citrus [9] 257419 Citrus Health and Rehabilitation Center 701 MEDICAL COURT EAST INVERNESS, FL 34452 4/11/2002

Pinellas [52] 258342 Oak Manor Healthcare & Rehabilitation Center 3500 OAK MANOR LANE LARGO, FL 33774 9/1/2002

Volusia [64] 258750 Indigo Manor 595 N WILLIAMSON BLVD DAYTONA BEACH, FL 32114 1/1/2001

Escambia [17] 258831 Haven of Our Lady of Peace 1900 SUMMIT BOULEVARD PENSACOLA , FL 32503 11/8/2001

Broward [6] 259080 Life Care Center at Inverrary 4300 ROCK ISLAND ROAD LAUDERHILL, FL 33319 1/30/2003

Lake [35] 259225 Lakeview Terrace Skilled Nursing Facility 110 LODGE TERRACE DR ALTOONA, FL 32702 1/3/2003

Santa Rosa [57] 259331 Pruitthealth - Santa Rosa 5530 NORTHROP ROAD MILTON, FL 32570 2/13/2003

Pasco [51] 259357 Life Care Center of New Port Richey 7400 TROUBLE CREEK ROAD NEW PORT RICHEY, FL 34653 2/11/2003

Hillsborough [29] 259462 The Nursing Center at University Village 12250 N 22ND ST TAMPA, FL 33612-4955 10/16/2002

Palm Beach [50] 259586 Hamlin Place 2180 HYPOLUXO ROAD LANTANA, FL 33462 11/30/2002

Osceola [49] 259870 Avante At St Cloud Inc 1301 KANSAS AVE SAINT CLOUD, FL 34769-5999 3/1/2003

Manatee [41] 259942 Riverfront Nursing and Rehab Center 105 15TH ST E BRADENTON, FL 34208 4/28/2003 5/11/2014

Sarasota [58] 260355 Sarasota Memorial Nursing And Rehabilitation Center 5640 RAND BLVD SARASOTA, FL 34238 1/1/2003

Volusia [64] 260371 Bridgeview Center 350 S RIDGEWOOD AVENUE ORMOND BEACH, FL 32174 5/1/2003

Lake [35] 260444 Bayview Center 301 S BAY ST EUSTIS, FL 32726 5/1/2003

Lake [35] 260452 Ruleme Center 2810 RULEME ST EUSTIS, FL 32726 5/1/2003

Pinellas [52] 260568 Tierra Pines Center 7380 ULMERTON RD LARGO, FL 33771 5/1/2003

Polk [53] 260576 Highlands Lake Center 4240 LAKELAND HIGHLANDS RD LAKELAND, FL 33813 5/1/2003

Volusia [64] 260649 Coquina Center 170 N CENTER STREET ORMOND BEACH, FL 32174 5/1/2003

Seminole [59] 260657 Island Lake Center 155 LANDOVER PLACE LONGWOOD, FL 32750 5/1/2003

Brevard [5] 260665 Indian River Center 7201 GREENBORO DR WEST MELBOURNE, FL 32904 5/1/2003

Duval [16] 260673 Riverwood Center 2802 PARENTAL HOME ROAD JACKSONVILLE, FL 32216 5/1/2003

Hillsborough [29] 260690 Fairway Oaks Center 13806 N 46TH ST TAMPA, FL 33613 5/1/2003

Dade [13] 260771 Sinai Plaza Nursing & Rehab Center 201 NE 112TH STREET MIAMI, FL 33161 6/7/2003

Pinellas [52] 261254 Alhambra Health And Rehabilitation Center 7501 38TH AVE N SAINT PETERSBURG, FL 33710 6/27/2003

Orange [48] 261611 Terra Vista Rehab And Health Center 1730 LUCERNE TERRACE ORLANDO, FL 32806 5/1/2003

(11)

AHCA

County Medicaid Number Provider Name Address Line1 City State Zip Date Active Date Inactive

St Lucie [56] 261637 Emerald Health Care Center 1655 SE WALTON ROAD PORT SAINT LUCIE, FL 34952 5/1/2003

Hillsborough [29] 261670 Hawthorne Health And Rehab Of Brandon 851 WEST LUMSDEN RD BRANDON, FL 33511 12/1/2001

Brevard [5] 263389 Atlantic Shores Nursing And Rehab Center 4251 STACK BLVD MELBOURNE, FL 32901 10/1/2003

Holmes [30] 263443 Bonifay Nursing And Rehab Center 306 WEST BROCK AVENUE BONIFAY , FL 32425 10/1/2003

Manatee [41] 263451 Riviera Palms Rehabilitation Center 926 HABEN BLVD PALMETTO, FL 34221 10/1/2003

Palm Beach [50] 263460 Boynton Beach Rehabilitation Center 9600 LAWRENCE RD BOYNTON BEACH, FL 33436-3300 10/1/2003

Citrus [9] 263478 Arbor Trail Rehab And Skilled Nursing Center 611 TURNER CAMP RD INVERNESS, FL 34453 10/1/2003

Pinellas [52] 263486 Pinellas Point Nursing And Rehab Center 5601 31ST ST S SAINT PETERSBURG, FL 33712 10/1/2003

Duval [16] 263494 Jacksonville Nursing And Rehab Center 4134 DUNN AVENUE JACKSONVILLE , FL 32218 10/1/2003

Volusia [64] 263508 Port Orange Nursing And Rehab Center 5600 VICTORIA GARDENS BLVD PORT ORANGE, FL 32127 10/1/2003

Baker [2] 263516 MacClenny Nursing And Rehab Center 755 S 5TH ST MACCLENNY, FL 32063 10/1/2003

Palm Beach [50] 263524 Medicana Nursing And Rehab Center 1710 LAKE WORTH ROAD LAKE WORTH, FL 33460 10/1/2003

St Lucie [56] 263532 Tiffany Hall Nursing And Rehab Center 1800 SE HILLMOOR DRIVE PORT SAINT LUCIE, FL 34952 10/1/2003

Orange [48] 263541 Metro West Nursing And Rehab Center 5900 WESTGATE DRIVE ORLANDO , FL 32835 10/1/2003

St Johns [55] 263559 Moultrie Creek Nursing And Rehab Center 200 MARINER HEALTH WAY SAINT AUGUSTINE, FL 32086 10/1/2003

Volusia [64] 263567 Orange City Nursing And Rehab Center 2810 ENTERPRISE RD DEBARY, FL 32713 10/1/2003

Hillsborough [29] 263575 Bayshore Pointe Nursing And Rehab Center 3117 W GANDY BLVD TAMPA, FL 33611-2927 12/1/2003

Brevard [5] 263583 Royal Oaks Nursing And Rehab Center 2225 KNOX MCRAE DR TITUSVILLE, FL 32780 10/1/2003

Seminole [59] 263591 Tuskawilla Nursing And Rehab Center 1024 WILLA SPRINGS DR WINTER SPRINGS, FL 32708 10/1/2003

Orange [48] 263605 Hunters Creek Nursing And Rehab Center 14155 TOWN LOOP BLVD ORLANDO, FL 32837 10/1/2003

Palm Beach [50] 263613 Boulevard Rehabilitation Center 2839 S SEACREST BLVD BOYNTON BEACH, FL 33435-7994 10/1/2003

Martin [43] 263621 Palm City Nursing & Rehab Center 2505 SW MARTIN HWY PALM CITY, FL 34990 10/1/2003

Pinellas [52] 263834 Bay Pointe Nursing Pavilion 4201 31ST ST S SAINT PETERSBURG, FL 33712 7/1/2003

Palm Beach [50] 263842 Boca Raton Rehabilitation Center 755 MEADOWS ROAD BOCA RATON, FL 33486 7/1/2003

Broward [6] 263851 Deerfield Beach Health and Rehabilitation Center 401 EAST SAMPLE ROAD POMPANO BEACH, FL 33064 7/1/2003

Lee [36] 263869 Rehab & Healthcare Center Of Cape Coral 2629 DEL PRADO BLVD CAPE CORAL, FL 33904 7/1/2003

Hillsborough [29] 263877 Carrollwood Care Center 15002 HUTCHINSON RD TAMPA, FL 33625 7/1/2003

Manatee [41] 263885 Casa Mora Rehabilitation and Extended Care 1902 59TH ST W BRADENTON, FL 34209 7/1/2003

Hernando [27] 263893 Evergreen Woods 7045 EVERGREEN WOODS TRL SPRING HILL, FL 34608 7/1/2003

Pinellas [52] 263907 Highland Pines Rehabilitation Center 1111 S HIGHLAND AVE CLEARWATER, FL 33756 7/1/2003

Palm Beach [50] 263915 The Rehabilitation Center Of The Palm Beaches 301 NORTHPOINTE PARKWAY WEST PALM BEACH, FL 33407 7/1/2003

Broward [6] 263923 Pompano Health and Rehabilitation Center 51 W SAMPLE ROAD POMPANO BEACH, FL 33064 7/1/2003

Seminole [59] 263931 Healthcare And Rehab Of Sanford 950 MELLONVILLE AVE SANFORD, FL 32771 7/1/2003

Hillsborough [29] 263940 Rehabilitation and Healthcare Center of Tampa 4411 N HABANA AVE TAMPA, FL 33614 7/1/2003

Pinellas [52] 263958 Abbey Rehabilitation And Nursing Center 7101 DR MARTIN LUTHER KING JR ST N SAINT PETERSBURG, FL 33702 7/1/2003

Highlands [28] 263966 Oaks At Avon 1010 US 27 N AVON PARK, FL 33825 7/1/2003

Brevard [5] 263974 Titusville Rehabilitation and Nursing Center 1705 JESS PARRISH CT TITUSVILLE, FL 32796 7/1/2003

Sarasota [58] 263982 Sarasota Health and Rehabilitation Center 1524 EAST AVENUE SOUTH SARASOTA, FL 34239 7/1/2003

Pasco [51] 263991 Windsor Woods Rehab And Healthcare Center 13719 DALLAS DR HUDSON, FL 34667 7/1/2003

Lee [36] 264008 Winkler Court 3250 WINKLER AVENUE EXTENSION FORT MYERS, FL 33916 7/1/2003

Lafayette [34] 264482 Lafayette Health Care Center 512 W MAIN ST MAYO, FL 32066 5/1/2003

Bay [3] 264491 Clifford Chester Sims State Veterans Nursing Home 4419 TRAM ROAD PANAMA CITY, FL 32404 11/5/2003

Orange [48] 264512 Conway Lakes Health & Rehabilitation Center 5201 CURRY FORD ROAD ORLANDO , FL 32812 12/1/2003

Pinellas [52] 264521 Belleair Health Care Center 1150 PONCE DE LEON BLVD CLEARWATER, FL 33756 12/1/2003

Pinellas [52] 264539 East Bay Rehabilitation Center 4470 E BAY DR CLEARWATER, FL 33764 12/1/2003

Brevard [5] 264547 Melbourne Terrace Rehabilitation Center 251 FLORIDA AVE MELBOURNE, FL 32901 12/1/2003

Leon [37] 264563 Centre Pointe Health and Rehab Center 2255 CENTERVILLE ROAD TALLAHASSEE , FL 32308 12/1/2003

Polk [53] 264571 Spring Lake Rehabilitation Center 1540 6TH ST NW WINTER HAVEN, FL 33881 12/1/2003

Lee [36] 265381 Life Care Center of Estero 3850 WILLIAMS ROAD ESTERO, FL 33928 10/23/2003

(12)

AHCA

County Medicaid Number Provider Name Address Line1 City State Zip Date Active Date Inactive

Dade [13] 265730 Hialeah Nursing and Rehabilitation Center 190 W 28TH STREET HIALEAH, FL 33010 9/1/2003

Marion [42] 266108 Life Care Center of Ocala 2800 SW 41ST ST OCALA, FL 34474 2/1/2004

Palm Beach [50] 266124 Oasis Health and Rehabilitation Center 1201 12TH AVENUE SOUTH LAKE WORTH, FL 33460 9/1/2003

Duval [16] 266281 Southpoint Terrace 4325 SOUTHPOINT BOULEVARD JACKSONVILLE, FL 32216 2/20/2004 7/1/2014

Hillsborough [29] 266612 Whispering Oaks 1514 E CHELSEA ST TAMPA, FL 33610 5/7/2003

Pinellas [52] 267724 Springs At Boca Ciega Bay 1255 PASADENA AVE S, SUITE C SOUTH PASADENA, FL 33707 1/1/2004

Dade [13] 267902 The Nursing Center at Mercy 3671 S MIAMI AVENUE MIAMI, FL 33133 3/1/2003

Duval [16] 268003 Lanier Terrace 12740 LANIER ROAD JACKSONVILLE, FL 32226-1704 9/1/2003

Dade [13] 268062 Susanna Wesley Health Center 5300 W 16TH AVENUE HIALEAH, FL 33012 7/1/2003

Brevard [5] 268186 Life Care Center of Palm Bay 175 VILLA NUEVA AVE PALM BAY, FL 32907 5/28/2004

Collier [11] 268585 Harborchase of Naples 7801 AIRPORT PULLING ROAD N NAPLES, FL 34109 1/1/2004

St Lucie [56] 268755 Abbiejean Russell Care Center LLC 700 S 29TH STREET FORT PIERCE, FL 34947 5/1/2004

Suwannee [61] 268763 Good Samaritan Center 10676 MARVIN JONES BLVD LIVE OAK, FL 32060 11/1/2003

Sarasota [58] 268780 Springs At Lake Pointe Woods 3280 LAKE POINTE BLVD SARASOTA, FL 34231 1/1/2004

Volusia [64] 269000 Majestic Oaks 901 VETERAN'S MEMORIAL PARKWAY ORANGE CITY, FL 32763 1/21/2003

Dade [13] 269107 Harmony Health Center 9820 N KENDALL DRIVE MIAMI, FL 33176 9/1/2003

Charlotte [8] 269492 Douglas Jacobson State Veterans Nursing Home 21281 GRAYTON TERRACE PORT CHARLOTTE, FL 33954 6/7/2004

Broward [6] 269697 Regents Park of Sunrise 9711 W OAKLAND PARK BLVD SUNRISE, FL 33351 6/1/2004

Orange [48] 269719 Regents Park of Winter Park 558 N SEMORAN BLVD WINTER PARK, FL 32792 6/1/2004

Duval [16] 269727 Regents Park of Jacksonville 8700 A C SKINNER PARKWAY JACKSONVILLE, FL 32256 6/1/2004

Pinellas [52] 281743 Jacaranda Manor 4250 66TH ST N SAINT PETERSBURG, FL 33709 10/15/2004

Dade [13] 282359 West Gables Health Care Center 2525 SW 75TH AVENUE MIAMI, FL 33155 10/1/2001

Volusia [64] 282464 Ridgecrest Nursing And Rehabilitation Center 1200 NORTH STONE STREET DELAND, FL 32720 11/3/2004

Dade [13] 282529 Coral Reef Nursing & Rehabilitation Center 9869 SW 152ND STREET MIAMI , FL 33157 1/12/2004

Pinellas [52] 282537 Palm Terrace Of St Petersburg 521 69TH AVE N SAINT PETERSBURG, FL 33702 10/29/2004

Volusia [64] 282553 The Terrace at Daytona Beach 1704 HUNTINGTON VILLAGE CIRCLE DAYTONA BEACH , FL 32114 3/1/2004 7/1/2014

Hendry [26] 282618 Palm Terrace of Clewiston 301 SOUTH GLORIA STREET CLEWISTON, FL 33440 10/29/2004

Polk [53] 282626 Palm Terrace of Lakeland 1919 LAKELAND HILLS BLVD LAKELAND, FL 33805 10/29/2004

Duval [16] 283193 Life Care Center of Jacksonville 4813 LENOIR AVENUE JACKSONVILLE, FL 32216 1/4/2005

Clay [10] 284289 Life Care Center of Orange Park 2145 KINGSLEY AVE ORANGE PARK, FL 32073 1/19/2005

Clay [10] 284785 The Terrace at Fleming Island 1125 FLEMING PLANTATION BLVD ORANGE PARK, FL 32003 3/11/2005 7/1/2014

Hillsborough [29] 284793 Brighton Gardens of Tampa 16702 NORTH DALE MABRY HWY TAMPA, FL 33618-1055 10/1/2003

Dade [13] 284823 Aventura Plaza Rehabilitation & Nursing Center 1800 N E 168TH STREET NORTH MIAMI BEACH, FL 33162 1/1/2002

Duval [16] 307998 Cypress Village 4600 MIDDLETON PARK CIR E JACKSONVILLE, FL 32224 4/6/2005 8/29/2014

Dade [13] 308242 Hebrew Home of South Beach 320 COLLINS AVENUE MIAMI BEACH , FL 33139 1/1/2002 10/22/2013

Dade [13] 308251 Ponce Plaza Nursing & Rehabilitation Center 335 SW 12 AVENUE MIAMI , FL 33130 1/1/2002

Pinellas [52] 309800 The Allegro At College Harbor 4600 54TH AVE S SAINT PETERSBURG, FL 33711 7/29/2005

Indian River [31] 310581 Atlantic Healthcare Center 3663 15TH AVENUE VERO BEACH, FL 32960 6/30/2005

Pinellas [52] 310841 St Mark Village 2655 NEBRASKA AVE PALM HARBOR, FL 34684 8/15/2005

Dade [13] 311308 South Pointe Plaza Rehabilitation And Nursing Center 42 COLLINS AVENUE MIAMI BEACH , FL 33139 11/3/2005

Charlotte [8] 311685 Life Care Center of Punta Gorda 450 SHREVE STREET PUNTA GORDA, FL 33950 7/29/2005

Volusia [64] 312045 SandalWood Nursing Center 1001 S BEACH STREET DAYTONA BEACH, FL 32114 7/31/2005

Putnam [54] 312142 Lakewood Nursing Center 100 N LAKE ST CRESCENT CITY, FL 32112 7/1/2005

Dixie [15] 312151 Cross City Rehabilitation & Health Care Center 583 NE 351 HWY CROSS CITY, FL 32628 8/22/2005

Putnam [54] 312274 Crestwood Nursing Center 501 S PALM AVE PALATKA, FL 32177 7/1/2005

Palm Beach [50] 312312 Savannah Cove 2090 N CONGRESS AVE WEST PALM BEACH , FL 33401 1/1/2006

Duval [16] 312371 Southlake Nursing and Rehabilitation Center 10680 OLD ST AUGUSTINE RD JACKSONVILLE, FL 32257 9/12/2005 5/1/2014

Orange [48] 312550 Savannah Cove 1301 W MAITLAND BLVD MAITLAND, FL 32751 1/1/2006

Broward [6] 312789 Children's Comprehensive Care Center Inc. 200 SE 19TH AVENUE POMPANO BEACH, FL 33060 7/1/2005

(13)

AHCA

County Medicaid Number Provider Name Address Line1 City State Zip Date Active Date Inactive

Seminole [59] 313718 Lutheran Haven Nursing Home 1525 HAVEN DRIVE OVIEDO, FL 32765 12/16/2005

Escambia [17] 315664 Life Care Center of Pensacola 3291 EAST OLIVE RD PENSACOLA, FL 32514 6/1/2006

Okaloosa [46] 316075 Westwood Health Care Center 1001 MAR-WALT DRIVE FORT WALTON BEACH, FL 32547 3/31/2006 12/5/2013

Pinellas [52] 316628 Laurellwood Nursing Center 3127 57TH AVE N SAINT PETERSBURG, FL 33714 12/1/2005

Pinellas [52] 316636 Harbourwood Health And Rehab Center 549 SKY HARBOR DR CLEARWATER, FL 33759 12/1/2005

Pinellas [52] 316644 Gracewood Rehabilitation And Nursing Care 8600 US HWY 19 N PINELLAS PARK, FL 33782 12/1/2005

Pinellas [52] 316652 Baywood Nursing Center 2000 17TH AVE S SAINT PETERSBURG, FL 33712 12/1/2005

Manatee [41] 317195 The Nursing Center At Freedom Village 6410 21ST AVE W BRADENTON, FL 34209 6/12/2006

Palm Beach [50] 317349 Darcy Hall of Life Care 2170 PALM BEACH LAKES BLVD WEST PALM BEACH, FL 33409 9/14/2006

Alachua [1] 317578 Parklands Rehabilitation and Nursing Center 1000 SW 16TH AVE GAINESVILLE, FL 32601 10/1/2006

Levy [38] 317586 Williston Rehabilitation and Nursing Center 300 NW 1ST AVE WILLISTON, FL 32696 10/1/2006

Lee [36] 318787 Citrus Gardens of Fort Myers 7173 CYPRESS DRIVE SW FORT MYERS, FL 33907-2994 1/15/2007

Broward [6] 318795 The Court At Palm Aire 2701 N COURSE DR POMPANO BEACH, FL 33069-3058 9/1/2006

Sarasota [58] 319244 Brookdale Palmer Ranch SNF 5111 PALMER RANCH PARKWAY SARASOTA, FL 34238 12/1/2006

Charlotte [8] 319325 Port Charlotte Rehabilitation Center 25325 RAMPART BLVD PORT CHARLOTTE, FL 33983 10/8/2004

Charlotte [8] 319333 Harbour Health Center 23013 WESTCHESTER BLVD PORT CHARLOTTE, FL 33980 7/1/2005

Duval [16] 319376 Brookdale Atrium Way 2 9960 ATRIUM WAY JACKSONVILLE , FL 32225 2/1/2007

Pasco [51] 320391 Zephyr Haven Health & Rehab Center, Inc. 38250 A AVE ZEPHYRHILLS, FL 33542 1/1/2007

Pasco [51] 320404 Zephyrhills Health & Rehab Center, Inc. 7350 DAIRY RD ZEPHYRHILLS, FL 33540 1/1/2007

Orange [48] 320412 Sunbelt Health & Rehab Center - Apopka, Inc. 305 EAST OAK STREET APOPKA, FL 32703 1/1/2007

Orange [48] 320421 East Orlando Health & Rehab Center, Inc. 250 SOUTH CHICKASAW TRAIL ORLANDO, FL 32825-3308 1/1/2007

Orange [48] 320439 Adventist Care Centers - Courtland, Inc. 730 COURTLAND STREET ORLANDO, FL 32804 1/1/2007

Seminole [59] 320463 Florida Living Nursing Center 3355 E SEMORAN BLVD APOPKA, FL 32703 1/1/2007

Lee [36] 320978 Lehigh Acres Health & Rehabilitation Center 1550 LEE BLVD LEHIGH ACRES, FL 33936 7/1/2007

Broward [6] 321303 Ft. Lauderdale Health & Rehab Center 2000 EAST COMMERCIAL BLVD FORT LAUDERDALE, FL 33308 7/1/2007 10/1/2014

Broward [6] 321532 The Palms Rehabilitation and Nursing Center 3370 NW 47TH TERRACE LAUDERDALE LAKES, FL 33319 1/1/2007

Dade [13] 323772 Coral Gables Nursing and Rehabilitation 7060 SW 8TH STREET MIAMI, FL 33144 11/1/2007

Sarasota [58] 323781 Tarpon Point Nursing and Rehabilitation Center 5157 PARK CLUB DRIVE SARASOTA , FL 34235 11/1/2007

Bay [3] 323799 St. Andrew's Bay Skilled Nursing and Rehabilitation 2100 JENKS AVE PANAMA CITY, FL 32405 11/1/2007

Dade [13] 324027 Hampton Court Nursing Center 16100 NW 2ND AVENUE NORTH MIAMI BEACH, FL 33169 11/1/2007

Pinellas [52] 324094 Advanced Rehabilitation & Health Center 401 FAIRWOOD AVE CLEARWATER, FL 33759 9/1/2007

Pinellas [52] 324108 Bayside Rehabilitation & Health Center 811 JACKSON ST N SAINT PETERSBURG, FL 33705 9/1/2007

Hillsborough [29] 324116 Excel Rehabilitation & Health Center 2811 CAMPUS HILL DR TAMPA, FL 33612 9/1/2007

Pasco [51] 324124 Madison Pointe Rehabilitation & Health Center 6020 INDIANA AVE NEW PORT RICHEY, FL 34653-3214 9/1/2007

Pinellas [52] 324132 Shore Acres Rehabilitation & Health Center 4500 INDIANAPOLIS ST NE SAINT PETERSBURG, FL 33703 9/1/2007

Hillsborough [29] 324141 Woodbridge Rehabilitation & Health Center 8720 JACKSON SPRINGS RD TAMPA, FL 33615-3210 9/1/2007

Dade [13] 324167 Palmetto Rehabilitation and Health Center 6750 WEST 22ND COURT HIALEAH, FL 33016 9/1/2007

Orange [48] 324175 Courtyards of Orlando 1900 MERCY DRIVE ORLANDO, FL 32808 9/1/2007

Highlands [28] 324213 Royal Care of Avon Park 1213 W STRATFORD RD AVON PARK, FL 33825 12/1/2007

Pinellas [52] 324230 Seminole Pavilion Rehabilitation & Nursing Service 10800 TEMPLE TERRACE SEMINOLE, FL 33772 7/20/2007

Pinellas [52] 324248 Freedom Square Rehabilitation & Nursing Services 10801 JOHNSON BLVD SEMINOLE, FL 33772 7/20/2007

Manatee [41] 324345 Heritage Park Care and Rehabilitation Center 2302 59TH ST W BRADENTON, FL 34209 11/1/2007

Washington [67] 324353 Washington Rehabilitation & Nursing Center 879 USERY ROAD CHIPLEY, FL 32428 11/1/2007

Walton [66] 324361 Chautauqua Rehabilitation & Nursing Center 785 S 2ND STREET DEFUNIAK SPRINGS, FL 32433 11/1/2007

Lee [36] 324370 Signature HealthCARE of College Park 13755 GOLF CLUB PKWY FORT MYERS, FL 33919 11/1/2007

Alachua [1] 324388 Signature HealthCARE of Gainesville 4000 SW 20TH AVE GAINESVILLE, FL 32607 11/1/2007

Jackson [32] 324396 Signature Healthcare of North Florida 1083 SANDERS AVENUE GRACEVILLE , FL 32440 11/1/2007

Dade [13] 324400 Signature HealthCARE Center of Waterford 8333 W OKEECHOBEE ROAD HIALEAH GARDENS , FL 33016 11/1/2007

Dade [13] 324418 Signature Healthcare of Brookwood Gardens 1990 S CANAL DRIVE HOMESTEAD, FL 33035 11/1/2007

References

Related documents

Violation: Unfit or incompetent by reason of negligence, habits or other cause; and guilty of unprofessional conduct, to wit: failure to maintain a record for each patient which

3.16 The IGT’s findings in respect of the code of settlement processes are that at a systemic level, the cases examined by the IGT generally evidenced compliance with Tax

implemented using two main methods; the first one is by using two real ELA816 RFID card readers to connect two departments at the same time, which are

Workspaces  allow  System  Administrators  to  grant  or  deny  operators  access  to  system 

All species of Pieris examined in this study have 3-colporate and oblate pollen tetrads having similar rugulate to rugulate-psilate (rarely psilate) exine with secondary

Other "innovations" emerging quite widely included: different term dates, use of unqualified teachers, setting own conditions of service (including

Survey questions focused on the approach to implementation and delivery of the Care Certificate training, the impact of the Care Certificate on the organisation, care workers and

Therefore, this study focused on the direct effect of social wellness integration strategies that were integrated into fifth grade science lesson plans within a general