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General NPI Number Information
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NPI Number | 1508207820
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Entity Type | Organization
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Legal Business Name | GULF COAST HEALTH SERVICES LLC
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 07/15/2013
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Provider Practice Location Address
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Address Line | 2344 BEE RIDGE RD SUITE 102
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City | SARASOTA
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State | FL
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Zip | 34239-6275
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Country | US
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Telephone | 941-929-1966
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Fax | 941-929-1977
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Provider Business Mailing Address
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Address Line | 2344 BEE RIDGE RD SUITE 102
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City | SARASOTA
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State | FL
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Zip | 34239-6275
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Country | US
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Telephone | 941-929-1966
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Fax | 941-929-1977
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MICHAEL JUCEAM
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Credential |
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Telephone | 941-929-1966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | HHA299992371
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HHA299992371
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License Number State | FL
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