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General NPI Number Information
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NPI Number | 1891839544
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Entity Type | Organization
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Legal Business Name | QI BY THE SEA, INC.
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 08/09/2013
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Provider Practice Location Address
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Address Line | 13357 OVERSEAS HWY
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City | MARATHON
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State | FL
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Zip | 33050-3550
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Country | US
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Telephone | 305-797-8527
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 420405
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City | SUMMERLAND KEY
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State | FL
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Zip | 33042-0405
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEAN A GORMLEY
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Credential | D.O.M., A.P., D.C.
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Telephone | 305-797-8527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | AP 751
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | AP 751
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | AP 751
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | AP 751
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 175L00000X
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Taxonomy Name | Homeopath
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License Number | AP 751
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number | AP 751
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | AP 751
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License Number State | FL
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Taxonomy #8
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | AP 751
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License Number State | FL
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Taxonomy #9
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | AP 751
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License Number State | FL
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Taxonomy #10
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP 751
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License Number State | FL
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