SURREY PLACE CARE CENTER
NPI 1366421836
Skilled Nursing Facility in Live Oak, FL

Active since January 12, 2006CLIA 10D0665144 · Waiver
110 LEE AVE SE, LIVE OAK, FL 32064(386) 364-5961 Get Directions Write a Review

NPPES record last updated: February 24, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Surrey Place Care Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SURREY PLACE CARE CENTER (NPI 1366421836) is a healthcare organization registered as a skilled nursing facility in Live Oak, Florida and active in the NPI registry since January 2006. The organization holds a CLIA Waiver certificate valid through November 18, 2026 and lists Paul Walczak, Ceo, as its authorized official.

NPPES Registry Identity

NPI1366421836
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameHQM OF SURREY PLACE, LLC
Location Address110 LEE AVE SELive Oak, FL 32064-9504
Mailing Address110 Lee Ave SeLive Oak, FL 32064-9504 · (386) 364-5961
Organization SubpartNo
Authorized OfficialPaul WalczakCeo · (561) 627-0664
Enumeration DateJanuary 12, 2006
Last NPPES UpdateFebruary 24, 2009
NPI 1366421836 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in FL · SNF1540096
Definition
(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.
110 LEE AVE SE, Live Oak, FL 32064

Other Names 1

Doing Business AsSurrey Place Care Center

Other Identifiers 3

Medicare ID-Type Unspecified10-5597FL · Medicare Provider Number
Medicaid025710900FL
Medicare NSC6105000001

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0665144

Surrey Place Nursing Center · Live Oak, FL
Active · expires Nov 18, 2026
CLIA Number10D0665144
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateNovember 19, 2024
Certificate Expiration DateNovember 18, 2026
Laboratory DirectorVanessa Gilliam
Laboratory Phone(561) 627-0664
Laboratory LocationSurrey Place Nursing Center110 Southeast Lee Ave, Live Oak, FL 32064
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Skilled Nursing Facility
110 LEE AVE SE
LIVE OAK, FL 32064
Skilled Nursing Facility
110 LEE AVE SE
LIVE OAK, FL 32064
Skilled Nursing Facility
110 LEE AVE SE
LIVE OAK, FL 32064

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Hqm Of Surrey Place, LLC's NPI number?

The NPI number for Hqm Of Surrey Place, LLC is 1366421836. It was assigned to this organization in the NPPES registry on January 12, 2006. The provider is doing business as Surrey Place Care Center.

Where is Hqm Of Surrey Place, LLC located?

Hqm Of Surrey Place, LLC is located at 110 Lee Ave SE, Live Oak, FL 32064. The listed phone number is (386) 364-5961.

What is Hqm Of Surrey Place, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Hqm Of Surrey Place, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0665144) is associated with this NPI, valid through November 18, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Hqm Of Surrey Place, LLC was last updated on February 24, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.