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NPI Code Detail

MEDICARE: JOHN BIRD COMMUNITY SUPPORTS

MEDICARE: JOHN BIRD COMMUNITY SUPPORTS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency000992301FL
2251B00000XCase Management Agency000992300FL

Other Identifiers

General Provider Information

NPI Number : 1184925752
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHN BIRD COMMUNITY SUPPORTS
Provider Business Mailing Address
First Line : 4788 253RD ST E
Second Line :
City : MYAKKA CITY
State : FL
Zip : 34251-8956
Country : US
Telephone Number : 941-920-1533
Fax Number : 941-362-9798
Provider Business Practice Location Address
First Line : 4788 253RD ST E
Second Line :
City : MYAKKA CITY
State : FL
Zip : 34251-8956
Country : US
Telephone Number : 941-920-1533
Fax Number : 941-362-9798
Authorized Official
Title or Position : VICE PRESIDENT
Name : MS. LINDA IERENE FLORES
Credential :
Telephone Number : 941-685-9684
Provider Enumeration Date : 11/12/2010
Last Update Date : 11/12/2010

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Directions to “JOHN BIRD COMMUNITY SUPPORTS ” Practice Location

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