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General NPI Number Information
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NPI Number | 1235545344
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Entity Type | Organization
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Legal Business Name | AFTER CARE CENTER OF FLORIDA AT HOLIDAY LLC
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 07/09/2014
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Provider Practice Location Address
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Address Line | 1812 US HIGHWAY 19
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City | HOLIDAY
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State | FL
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Zip | 34691-5535
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Country | US
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Telephone | 727-943-0300
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Fax | 727-943-0339
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Provider Business Mailing Address
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Address Line | 1812 US HIGHWAY 19
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City | HOLIDAY
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State | FL
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Zip | 34691-5535
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Country | US
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Telephone | 727-943-0300
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Fax | 727-943-0339
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MISS DONNA BORGIA
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Credential |
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Telephone | 727-943-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9101542
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | ARNP9196368
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH7280
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License Number State | FL
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