OrganizationSovereign Healthcare Of Orlando, Llc(Hunter'S Creek Nursing & Rehab Center)Skilled Nursing FacilityNursing & Custodial Care FacilitiesPractice Address14155 Town Loop Blvd, Orlando, FL 32837-6185(407) 541-2600(404) 574-2100PECOS EnrollmentBased on the most recent information from CMS, provider Sovereign Healthcare Of Orlando, Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1235126806Provider TypeOrganizationFull NameSovereign Healthcare Of Orlando, LlcOther NameHunter'S Creek Nursing & Rehab CenterSubpartNoEnumeration Date9/29/2005Last Updated9/24/2014Contact InformationPractice LocationPractice Address14155 Town Loop Blvd, Orlando, FL 32837-6185Phone(407) 541-2600Fax(407) 541-2700Mailing LocationMailing Address5887 Glenridge Dr, Suite 150, Atlanta, GA 30328-5574Phone(404) 574-2100Fax(404) 574-2105Authorized OfficialNameCronquist, R. Mark (Manager)Phone(404) 574-2100Provider TaxonomiesCodeDescriptionLicenseCode314000000XPrimaryDescriptionSkilled Nursing FacilityNursing & Custodial Care FacilitiesLicenseSNF130470987FloridaProvider IdentifiersIDDescriptionIssuerID026360500DescriptionMedicaidIssuerUnlistedFloridaIDV673P-5345DescriptionOtherIssuerVA