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General NPI Number Information
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NPI Number | 1942237227
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Entity Type | Organization
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Legal Business Name | TREASURE COAST MEDICAL SERVICES, INC.
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 02/23/2012
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Provider Practice Location Address
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Address Line | 3755 7TH TER SUITE 102,
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City | VERO BEACH
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State | FL
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Zip | 32960-6528
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Country | US
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Telephone | 772-770-2464
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Fax | 772-770-6323
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Provider Business Mailing Address
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Address Line | 3755 7TH TER SUITE 102
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City | VERO BEACH
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State | FL
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Zip | 32960-6528
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Country | US
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Telephone | 772-770-2464
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Fax | 772-770-6323
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Authorized Official
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Title or Position | CEO
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Name | MR. JAMES ALLEN ROGERS
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Credential | RT(N) CNMT
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Telephone | 772-770-2464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | HCC4619
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License Number State | FL
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