MEDICARE: SUNCOAST TOTAL HEALTHCARE OF PASCO LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1285917278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNCOAST TOTAL HEALTHCARE OF PASCO LLC

Provider Business Mailing Address
First Line	:	6710 EMBASSY BLVD
Second Line	:	SUITE 105
City	:	PORT RICHEY
State	:	FL
Zip	:	34668-7754
Country	:	US
Telephone Number	:	727-848-3377
Fax Number	:	727-848-3534

Provider Business Practice Location Address
First Line	:	6710 EMBASSY BLVD
Second Line	:	SUITE 105
City	:	PORT RICHEY
State	:	FL
Zip	:	34668-7754
Country	:	US
Telephone Number	:	727-848-3377
Fax Number	:	727-848-3534

Authorized Official
Title or Position	:	CHIROPRACTOR/CO-OWNER
Name	:	DR. ADAM ROSOFF
Credential	:	DC
Telephone Number	:	727-848-3377

Provider Enumeration Date	:	09/26/2011
Last Update Date	:	09/04/2012

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