MEDICARE: MR. GARY ROCCO LOFFREDO

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	251E00000X	Home Health Agency	299994518	FL

General Provider Information

NPI Number	:	1669093332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GARY ROCCO LOFFREDO

Provider Business Mailing Address
First Line	:	3313 W COMMERCIAL BLVD STE 130
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-3413
Country	:	US
Telephone Number	:	954-396-1541
Fax Number	:

Provider Business Practice Location Address
First Line	:	3313 W COMMERCIAL BLVD STE 130
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-3413
Country	:	US
Telephone Number	:	954-396-1541
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2020
Last Update Date	:	11/27/2023

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