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General NPI Number Information
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NPI Number | 1336475359
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Entity Type | Organization
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Legal Business Name | GOLD TEAM HOME HEALTH MEDICAL SUPPLIES LLC
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Dates
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Enumeration Date | 10/26/2009
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Last Update Date | 08/27/2013
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Provider Practice Location Address
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Address Line | 10616 RIVERVIEW DR
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City | RIVERVIEW
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State | FL
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Zip | 33578-4329
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Country | US
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Telephone | 813-662-0307
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Fax | 888-679-8810
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Provider Business Mailing Address
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Address Line | 10616 RIVERVIEW DR
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City | RIVERVIEW
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State | FL
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Zip | 33578-4329
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Country | US
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Telephone | 813-443-0528
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. FELIX E OMORODION
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Credential |
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Telephone | 813-443-0528
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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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