Healthcare Provider Details

I. General information

NPI: 1386548279
Provider Name (Legal Business Name): DR GULF COAST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 TAMIAMI TRL S
NOKOMIS FL
34275-3136
US

IV. Provider business mailing address

227 CASSANO DR
NOKOMIS FL
34275-2141
US

V. Phone/Fax

Practice location:
  • Phone: 941-451-5558
  • Fax:
Mailing address:
  • Phone: 512-808-3015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: LOUISA TOMAIO
Title or Position: OWER
Credential: DAC
Phone: 512-808-3015