Healthcare Provider Details

I. General information

NPI: 1730872508
Provider Name (Legal Business Name): GIA FFF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2023
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9442 BARNSTEAD LN
PORT RICHEY FL
34668-4303
US

IV. Provider business mailing address

9442 BARNSTEAD LN
PORT RICHEY FL
34668-4303
US

V. Phone/Fax

Practice location:
  • Phone: 727-505-9877
  • Fax:
Mailing address:
  • Phone: 727-505-9877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RUSSELL GIRESI
Title or Position: OWNER
Credential: BA PSY
Phone: 727-505-9877