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Contact Information

IVAN LOPEZLLAVORE, PTA
3011 SABAL BEND DR NE
WINTER HAVEN, FL33881-5108
 Phone: 863-651-3040
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Nursing Home Administrator

376G00000X
 

Physical Therapy Assistant

225200000X
Indicates primary specialty

NPI Profile & details for

NPI # 1740419225
Entity Organization
Organization subpart 1 Not specified
Enumeration date 07/06/2009
Last updated 09/20/2024 - More than a year ago
Identifiers
FL License # NH4843
FL License # PTA20203
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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