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General NPI Number Information
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NPI Number | 1154375715
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Entity Type | Organization
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Legal Business Name | LEGACY HEALTHCARE INC
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 07/13/2007
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Provider Practice Location Address
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Address Line | 7254 S TAMIAMI TRL
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City | SARASOTA
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State | FL
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Zip | 34231-5554
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Country | US
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Telephone | 941-924-7819
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Fax | 941-924-7919
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Provider Business Mailing Address
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Address Line | 1144 TALLEVAST RD SUITE 105
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City | SARASOTA
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State | FL
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Zip | 34243-3267
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Country | US
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Telephone | 941-355-9601
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Fax | 941-355-9608
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. CESAR CHACON
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Credential |
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Telephone | 941-302-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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