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NPI Code Detail

MEDICARE: GULF COAST MED CTR PHYSICAL THERAPY

MEDICARE: GULF COAST MED CTR PHYSICAL THERAPY
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
1225700000XMassage Therapist
2207Q00000XFamily Medicine Physician
3207R00000XInternal Medicine Physician
4225100000XPhysical Therapist

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DE6703OTHERFLRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101589OTHERFLUNIVERSAL HEALTH CARE

General Provider Information

NPI Number : 1700852357
Entity Type Code : Organization
Provider Name (Legal Business Name) : GULF COAST MED CTR PHYSICAL THERAPY
Provider Business Mailing Address
First Line : 11528 US HIGHWAY 19
Second Line :
City : PORT RICHEY
State : FL
Zip : 34668-1442
Country : US
Telephone Number : 727-861-4770
Fax Number : 727-861-3351
Provider Business Practice Location Address
First Line : 11528 US HIGHWAY 19
Second Line :
City : PORT RICHEY
State : FL
Zip : 34668-1442
Country : US
Telephone Number : 727-861-4770
Fax Number : 727-861-3351
Authorized Official
Title or Position : FACILITIES DIRECTOR
Name : LORI BRIENZA
Credential : RN, LHRM, CCS-P
Telephone Number : 727-868-2151
Provider Enumeration Date : 02/24/2006
Last Update Date : 08/27/2012

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1346244100 — S M S DO PA
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1518945500 — DOUGLAS A JORDAN JR. D.P.M.
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1437125002 — MICHAEL S STROBBE D.O.
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PORT RICHEY, FL
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Practice Location Address:
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1447413711 — CHRISTA M. SMITH DPT
Practice Location Address:
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34668-1442
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Practice Fax: 727-861-3351

Directions to “GULF COAST MED CTR PHYSICAL THERAPY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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