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General NPI Number Information
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NPI Number | 1548049455
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Entity Type | Organization
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Legal Business Name | START CARE PPEC
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Dates
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Enumeration Date | 09/28/2023
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 1945 NORTHGATE BLVD
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City | SARASOTA
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State | FL
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Zip | 34234-2143
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Country | US
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Telephone | 786-461-5784
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Fax |
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Provider Business Mailing Address
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Address Line | 3991 PALAU DR
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City | SARASOTA
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State | FL
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Zip | 34241-5842
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Country | US
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Telephone | 786-461-5784
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JUAN CRUZ LASSALLE
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Credential |
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Telephone | 786-461-5784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics 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 | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number |
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License Number State |
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