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General NPI Number Information
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NPI Number | 1184391831
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Entity Type | Organization
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Legal Business Name | CONSANO HEALTH INC
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Dates
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Enumeration Date | 08/30/2021
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Last Update Date | 08/30/2021
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Provider Practice Location Address
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Address Line | 120 E MAIN ST STE B
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City | PENSACOLA
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State | FL
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Zip | 32502-6096
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Country | US
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Telephone | 734-389-5832
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Fax |
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Provider Business Mailing Address
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Address Line | 259 S E ST
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City | PENSACOLA
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State | FL
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Zip | 32502-4569
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Country | US
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Telephone | 734-389-5832
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | DR. GERALD MASTAW JR.
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Credential | MD
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Telephone | 734-389-5832
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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