Healthcare Provider Details

I. General information

NPI: 1083178412
Provider Name (Legal Business Name): SPECIALTY CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2019
Last Update Date: 01/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 SE 43RD ST
GAINESVILLE FL
32641-7665
US

IV. Provider business mailing address

PO BOX 483
OCALA FL
34478-0483
US

V. Phone/Fax

Practice location:
  • Phone: 352-209-2431
  • Fax: 215-559-6336
Mailing address:
  • Phone: 352-258-4015
  • Fax: 215-559-6336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EDWARD JEROME PORTER
Title or Position: DIRECTOR
Credential: RN
Phone: 352-258-4015