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General NPI Number Information
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NPI Number | 1831305390
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Entity Type | Organization
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Legal Business Name | BROTHERS CARE INC
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3475 FOXHALL DR
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City | HOLIDAY
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State | FL
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Zip | 34691-2526
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Country | US
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Telephone | 727-243-2049
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Fax | 813-996-2454
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Provider Business Mailing Address
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Address Line | 15818 LEATHERLEAF LN
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City | LAND O LAKES
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State | FL
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Zip | 34638-7912
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Country | US
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Telephone | 813-996-9832
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Fax | 813-996-2454
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Authorized Official
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Title or Position | OWNER
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Name | JEFFREY MICHAEL GURNEY
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Credential |
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Telephone | 813-996-9832
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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