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General NPI Number Information
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NPI Number | 1811044894
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Entity Type | Organization
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Legal Business Name | GULF COAST THERAPY ASSOCIATES INC.
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 11/22/2021
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Provider Practice Location Address
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Address Line | 2110 FLEISCHMANN RD
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City | TALLAHASSEE
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State | FL
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Zip | 32308-0562
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Country | US
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Telephone | 941-624-6222
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Fax | 941-624-6821
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Provider Business Mailing Address
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Address Line | 4933 OLD GREENWOOD RD
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City | FORT SMITH
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State | AR
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Zip | 72903-6906
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Country | US
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Telephone | 479-201-6147
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Fax | 479-401-2239
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Authorized Official
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Title or Position | VICE PRESIDENT - FINANCE
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Name | BRITT JEFFCOAT
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Credential |
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Telephone | 972-372-6799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA6185
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT11068
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number | OT1055
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT15960
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License Number State | FL
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