=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285917278
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SUNCOAST TOTAL HEALTHCARE OF PASCO LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/26/2011
-----------------------------------------------------
Last Update Date | 09/04/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6710 EMBASSY BLVD SUITE 105
-----------------------------------------------------
City | PORT RICHEY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34668-7754
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-848-3377
-----------------------------------------------------
Fax | 727-848-3534
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6710 EMBASSY BLVD SUITE 105
-----------------------------------------------------
City | PORT RICHEY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34668-7754
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-848-3377
-----------------------------------------------------
Fax | 727-848-3534
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIROPRACTOR/CO-OWNER
-----------------------------------------------------
Name | DR. ADAM ROSOFF
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 727-848-3377
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------