Provider Demographics
NPI:1538254222
Name:OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA INC
Entity type:Organization
Organization Name:OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER BILLING COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CAVAIUOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-548-1016
Mailing Address - Street 1:5100 SW 25TH BLVD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-3984
Mailing Address - Country:US
Mailing Address - Phone:352-548-1000
Mailing Address - Fax:352-548-1015
Practice Address - Street 1:2660 SW 53RD LN
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-3981
Practice Address - Country:US
Practice Address - Phone:352-548-1142
Practice Address - Fax:352-548-1139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106066Medicare Oscar/Certification