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General NPI Number Information
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NPI Number | 1184052904
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Entity Type | Organization
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Legal Business Name | SUNCOAST LOVING CARE, LLC
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Dates
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Enumeration Date | 10/15/2013
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Last Update Date | 06/29/2018
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Provider Practice Location Address
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Address Line | 6703 14TH ST W SUITE 208
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City | BRADENTON
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State | FL
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Zip | 34207
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Country | US
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Telephone | 941-961-0029
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Fax |
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Provider Business Mailing Address
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Address Line | 1770 BEN FRANKLIN DR UNIT 506
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City | SARASOTA
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State | FL
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Zip | 34236-2323
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Country | US
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Telephone | 941-961-0029
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOLANTA IZMIRLIYAN
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Credential |
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Telephone | 941-961-0029
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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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