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General NPI Number Information
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NPI Number | 1922330422
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Entity Type | Organization
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Legal Business Name | SPECIALTY NURSING CORPS. INC.
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Dates
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Enumeration Date | 02/08/2010
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Last Update Date | 02/08/2010
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Provider Practice Location Address
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Address Line | 10018 PARK PLACE AVE
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City | RIVERVIEW
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State | FL
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Zip | 33578-5303
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Country | US
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Telephone | 813-677-4700
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Fax | 813-425-9774
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Provider Business Mailing Address
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Address Line | 10018 PARK PLACE AVE
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City | RIVERVIEW
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State | FL
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Zip | 33578-5303
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Country | US
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Telephone | 813-677-4700
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Fax | 813-425-9774
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JASON ALAN GATLIN
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Credential | RN
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Telephone | 813-677-4700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 30211422
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License Number State | FL
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