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General NPI Number Information
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NPI Number | 1083925002
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Entity Type | Organization
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Legal Business Name | FIRSTLANTIC HEALTHCARE INC OF WEST FLORIDA
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Dates
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Enumeration Date | 06/24/2010
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Last Update Date | 10/19/2010
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Provider Practice Location Address
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Address Line | 2127 S TAMIAMI TRL SUITE 27
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City | OSPREY
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State | FL
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Zip | 34229-9695
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Country | US
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Telephone | 561-243-7979
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Fax | 561-272-6018
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Provider Business Mailing Address
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Address Line | 2605 W ATLANTIC AVE BUILDING A202
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City | DELRAY BEACH
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State | FL
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Zip | 33445-4413
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Country | US
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Telephone | 561-243-7979
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Fax | 561-272-6018
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Authorized Official
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Title or Position | OWNER-COO
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Name | BART DELSING
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Credential |
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Telephone | 561-243-7979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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