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General NPI Number Information
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NPI Number | 1306883962
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Entity Type | Organization
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Legal Business Name | LEGACY HEALTHCARE INC
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 06/02/2010
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Provider Practice Location Address
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Address Line | 3030 UNIVERSITY PKWY
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City | SARASOTA
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State | FL
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Zip | 34243-2502
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Country | US
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Telephone | 941-359-8233
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Fax | 941-359-8255
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Provider Business Mailing Address
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Address Line | 8175 US HIGHWAY 301 N
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City | PARRISH
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State | FL
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Zip | 34219-8669
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Country | US
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Telephone | 941-729-0003
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Fax | 941-729-0004
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. CESAR CHACON
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Credential |
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Telephone | 941-302-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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