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General NPI Number Information
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NPI Number | 1346715778
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Entity Type | Organization
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Legal Business Name | ADVANCED CARE HOUSE CALLS OF FLORIDA, LLC
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Dates
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Enumeration Date | 10/12/2018
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Last Update Date | 01/29/2020
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Provider Practice Location Address
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Address Line | 401 E CHASE ST STE 200
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City | PENSACOLA
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State | FL
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Zip | 32502-6160
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Country | US
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Telephone | 850-208-8883
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Fax | 250-760-0951
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Provider Business Mailing Address
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Address Line | PO BOX 51266
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City | LAFAYETTE
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State | LA
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Zip | 70505-1266
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Country | US
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Telephone | 337-233-1307
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | NICHOLAS GACHASSIN III
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Credential |
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Telephone | 337-233-1307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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