SOVEREIGN HEALTHCARE OF TAMPA, LLC (NPI# 1932196508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932196508 |
| Entity Type | Organization |
| Organization Name | SOVEREIGN HEALTHCARE OF TAMPA, LLC |
| Other Organization Name | BAYSHORE POINT NURSING & REHAB CENTER |
| Practice Address |
3117 W Gandy Blvd Tampa FL 33611-2927 |
| Mailing Address |
5887 Glenridge Dr Suite 150 Atlanta GA 30328-5574 |
| Practice Telephone | 8132615500 |
| Practice Fax Number | 8132615555 |
| Mailing Telephone | 4045742100 |
| Mailing Fax Number | 4045742105 |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2014-09-24 |
| Authorized Official Name | MR. R. MARK CRONQUIST (MANAGER) |
| Authorized Official Telephone | 4045742100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | SNF10410962 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | V673P-5341 | 01 | |
| FL | 026357500 | 05 |
| Other Name | Type Code |
|---|---|
| Bayshore Point Nursing & Rehab Center | Doing Business As Name - Organization |
| Street Address |
3117 W GANDY BLVD |
| City | TAMPA |
| State | FL |
| Zip Code | 33611-2927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578956603 | Felicia Walker | Nurse Practitioner | 3117 W Gandy Blvd, Tampa, FL 33611-2927 | 2015-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912519224 | Health & Glow Primary Care & Med Spa LLC | Internal Medicine | 4331 S Manhattan Ave, Tampa, FL 33611 | 2020-08-18 |
| 1245867597 | Susannah M Bultron | Home Health | 1663 Williambrg Sq, 1663 Williambrg Sq, Tampa, FL 33611 | 2020-03-26 |
| 1265077499 | Jenna Davis | Counselor | 4517 S Shamrock Rd, Tampa, FL 33611 | 2019-11-12 |
| 1023585114 | Samantha Lee Hamlin | Dietitian, Registered | 4003 S West Shore Blvd, Apt 4810, Tampa, FL 33611 | 2018-10-27 |
| 1023502572 | Sunset Chiropractic P.a. | Chiropractor | 3826 South Dale Mabry Hwy, South Tampa, FL 33611 | 2018-06-19 |
| 1033654843 | Nicole A Devlieger | Specialist/Technologist | 4539 S Dale Mabry Hwy Ste 110, Tampa, FL 33611 | 2017-01-03 |
| 1740633064 | Charles Lindsey | Case Manager/Care Coordinator | 5215 South Westshore Blvd. #31, Tampa, FL 33611 | 2016-07-21 |
| 1699145078 | Sarah Milam | Physical Therapist | 3111 W.martin Luther King Jr Blvd, Suite # 500, Tampa, FL 33611 | 2015-09-29 |
| 1912399163 | Robert Robertson | Pharmacist | 4317 Gandy Blvd, Tampa, FL 33611 | 2015-02-25 |
| 1730514225 | Charles Samuel Mahan | Obstetrics & Gynecology | 3111 E. Fletcher Av., Tampa, FL 33611 | 2013-09-04 |
| Find all providers in zip 33611 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265846174 | Riverwood Health Nh LLC | Skilled Nursing Facility | 4042 Park Oaks Blvd Ste 300, Tampa, FL 33610-9539 | 2014-06-18 |
| 1710317532 | Bvm Lakeshore LLC | Skilled Nursing Facility | 16001 Lakeshore Villa Drive, Tampa, FL 33613 | 2013-11-14 |
| 1952677908 | Geidy Hernandez | Skilled Nursing Facility | 5126 Net Dr, Tampa, FL 33634-5095 | 2012-03-23 |
| 1215163662 | Progressus Therapy | Skilled Nursing Facility | 10014 N Dale Mabry Hwy # C-100, Tampa, FL 33618-4426 | 2009-05-29 |
| 1518126408 | Sf Tampa LLC | Skilled Nursing Facility | 1818 East Fletcher Avenue, Tampa, FL 33612-3770 | 2008-06-05 |
| 1568546513 | Canterbury Tower Inc. | Skilled Nursing Facility | 3501 Bayshore Blvd, Tampa, FL 33629-8901 | 2006-10-25 |
| 1649227414 | Manor Care - Carrollwood of Tampa Fl, LLC | Skilled Nursing Facility | 3030 W Bearss Ave, Tampa, FL 33618-1811 | 2006-05-27 |
| 1932155918 | Fletcher Health Care Associates LLC | Skilled Nursing Facility | 518 W Fletcher Ave, Tampa, FL 33612-3419 | 2006-05-25 |
| 1699728626 | Solomon Holdings I - The Triangle LLC | Skilled Nursing Facility | 16702 N Dale Mabry Hwy, Tampa, FL 33618-1055 | 2006-05-19 |
| 1316916281 | Tr & Snf Inc | Skilled Nursing Facility | 12250 N 22nd St, Tampa, FL 33884 | 2006-03-14 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.