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General NPI Number Information
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NPI Number | 1487765566
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Entity Type | Organization
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Legal Business Name | GULF COAST ORTHOPEDIC CENTER
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 01/26/2017
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Provider Practice Location Address
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Address Line | 7315 HUDSON AVE
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City | HUDSON
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State | FL
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Zip | 34667-1158
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Country | US
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Telephone | 727-868-9563
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Fax | 727-869-6909
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Provider Business Mailing Address
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Address Line | PO BOX 5515
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City | HUDSON
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State | FL
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Zip | 34674-5515
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Country | US
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Telephone | 727-868-9563
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Fax | 727-869-6909
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MRS. LISA DAWN HANSHEW
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Credential | CPC
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Telephone | 727-868-9563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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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 | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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