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General NPI Number Information
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NPI Number | 1861754038
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Entity Type | Organization
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Legal Business Name | EMERALD CONTRACTORS
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Dates
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Enumeration Date | 06/13/2012
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Last Update Date | 06/13/2012
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Provider Practice Location Address
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Address Line | 1118 E COURT ST
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-5409
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Country | US
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Telephone | 727-943-9046
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Fax |
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Provider Business Mailing Address
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Address Line | 1118 E COURT ST
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-5409
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Country | US
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Telephone | 727-943-9046
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN MARZULLI
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Credential |
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Telephone | 727-943-9046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number | CGC-008986
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License Number State | FL
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