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NPI 1598410185

NPI 1598410185 : SIGNATURE COORDINATION & CONSULT : FORT PIERCE, FL

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General NPI Number Information
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    NPI Number           |    1598410185
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    Entity Type          |    Organization 
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    Legal Business Name  |    SIGNATURE COORDINATION & CONSULT 
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Dates
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    Enumeration Date     |    02/13/2022
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    Last Update Date     |    02/13/2022
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Provider Practice Location Address
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    Address Line         |    1221 DELAWARE AVE FL 2 
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    City                 |    FORT PIERCE
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    State                |    FL
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    Zip                  |    34950-4084
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    Country              |    US
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    Telephone            |    954-899-0954
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1221 DELAWARE AVE FL 2 
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    City                 |    FORT PIERCE
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    State                |    FL
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    Zip                  |    34950-4084
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    Country              |    US
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    Telephone            |    954-899-0954
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     LEA G STONOM 
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    Credential           |    
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    Telephone            |    954-899-0954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251B00000X
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    Taxonomy Name        |    Case Management Agency
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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        |    171M00000X
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    Taxonomy Name        |    Case Manager/Care Coordinator
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    License Number       |    
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    License Number State |    
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