Healthcare Provider Details

I. General information

NPI: 1649557182
Provider Name (Legal Business Name): GREAR HOPE INPATIENT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2011
Last Update Date: 06/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11375 CORTEZ BLVD
BROOKSVILLE FL
34613-5409
US

IV. Provider business mailing address

13737 NOEL RD SUITE 650
DALLAS TX
75240-1331
US

V. Phone/Fax

Practice location:
  • Phone: 352-596-6632
  • Fax: 352-597-6018
Mailing address:
  • Phone: 469-401-2386
  • Fax: 214-712-2444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. GREGORY J. BYRNE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 469-401-2386