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General NPI Number Information
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NPI Number | 1295111201
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Entity Type | Organization
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Legal Business Name | GAVIOTA CARE INC
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Dates
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Enumeration Date | 08/03/2015
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Last Update Date | 08/03/2015
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Provider Practice Location Address
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Address Line | 2461 EVERGLADES BLVD N
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City | NAPLES
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State | FL
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Zip | 34120-5540
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Country | US
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Telephone | 239-285-1392
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Fax | 941-462-1868
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Provider Business Mailing Address
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Address Line | 2461 EVERGLADES BLVD N
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City | NAPLES
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State | FL
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Zip | 34120-5540
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Country | US
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Telephone | 239-285-1392
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Fax | 941-462-1868
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | VIVIAN ORTEGA
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Credential |
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Telephone | 239-285-1392
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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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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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