Sovereign Healthcare of Port Orange, LLC
Sovereign Healthcare of Port Orange, LLC is a Skilled Nursing Facility in Port Orange, Florida. Licensed in Florida. Registered with an NPI since 2005.
- Licensed in
- FL
- In the registry since
- 2005
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
5600 Victoria Gardens BlvdPort Orange, FL 32127-7914 Not confirmed with CMS for 12 years — call before visiting
Phone: (386) 760-7773
Fax: (386) 760-8949
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Skilled Nursing Facility (primary) | Taxonomy 314000000X · Licence SNF130471000 (FL) |
|---|
Record details
| NPI number | 1710974423 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | R. Cronquist — Manager · (404) 574-2100 |
| Other names | Port Orange Nursing & Rehab Center |
| NPI enumerated | September 29, 2005 |
| Last updated in NPPES | September 24, 2014 |
| Mailing address | 5887 Glenridge Dr, Suite 150, Atlanta, GA 30328-5574 |
Clinicians affiliated with this facility
- Kristin L Wulff, MD Family Medicine Physician · Daytona Beach, FL