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General NPI Number Information
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NPI Number | 1740707553
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Entity Type | Organization
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Legal Business Name | GURU HEALTHCARE, LLC
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Dates
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Enumeration Date | 08/23/2017
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Last Update Date | 08/23/2017
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Provider Practice Location Address
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Address Line | 215 W MICKEY MANTLE PATH
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City | HERNANDO
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State | FL
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Zip | 34442-5190
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Country | US
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Telephone | 929-374-4268
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Fax |
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Provider Business Mailing Address
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Address Line | 6752 W GULF TO LAKE HWY STE 204
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-9348
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Country | US
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Telephone | 929-374-4268
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Fax | 929-214-4268
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRIS GRANT
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Credential |
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Telephone | 352-566-2751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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