Healthcare Provider Details

I. General information

NPI: 1063201077
Provider Name (Legal Business Name): WESTCARE GULFCOAST FLORIDA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3491 GANDY BLVD N STE 203
PINELLAS PARK FL
33781-2654
US

IV. Provider business mailing address

1735 MARTIN LUTHER KING ST S
SAINT PETERSBURG FL
33705-2404
US

V. Phone/Fax

Practice location:
  • Phone: 727-490-6767
  • Fax:
Mailing address:
  • Phone: 727-620-1082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DANNY BLANCO
Title or Position: CHIEF OPERATIONS OFFICER
Credential:
Phone: 727-490-6767