Healthcare Provider Details

I. General information

NPI: 1528263332
Provider Name (Legal Business Name): RAMPART GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 05/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 WILLARD ST SUITE A
COCOA FL
32922-7984
US

IV. Provider business mailing address

234 WILLARD STREET SUITE A
COCOA FL
32922-7984
US

V. Phone/Fax

Practice location:
  • Phone: 321-631-9014
  • Fax: 321-631-8010
Mailing address:
  • Phone: 321-631-9014
  • Fax: 321-631-8010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number9030
License Number StateFL

VIII. Authorized Official

Name: MARIANNA HUTCHINSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 321-631-9014