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General NPI Number Information
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NPI Number | 1134005283
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Entity Type | Individual
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Provider Name | GRETCHEN PERRY
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Gender | Female
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Dates
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Enumeration Date | 08/14/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 2533 TEMPLEWOOD DR
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City | HOLIDAY
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State | FL
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Zip | 34690-3839
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Country | US
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Telephone | 727-648-7722
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Fax |
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Provider Business Mailing Address
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Address Line | 13963 CADEN GLEN DR
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City | HUDSON
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State | FL
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Zip | 34669-5022
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Country | US
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Telephone | 727-648-7722
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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