Healthcare Provider Details

I. General information

NPI: 1548049455
Provider Name (Legal Business Name): START CARE PPEC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2023
Last Update Date: 09/29/2023
Certification Date: 09/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 NORTHGATE BLVD
SARASOTA FL
34234-2143
US

IV. Provider business mailing address

3991 PALAU DR
SARASOTA FL
34241-5842
US

V. Phone/Fax

Practice location:
  • Phone: 786-461-5784
  • Fax:
Mailing address:
  • Phone: 786-461-5784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3140N1450X
TaxonomyPediatric Skilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JUAN CRUZ LASSALLE
Title or Position: ADMINISTRATOR
Credential:
Phone: 786-461-5784