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NPI Code Detail

MEDICARE: EASTERSEALS OF SOUTHWEST FLORIDA, INC

MEDICARE: EASTERSEALS OF SOUTHWEST FLORIDA, INC
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
1251C00000XDevelopmentally Disabled Services Day Training Agency
2261Q00000XClinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396890422
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTERSEALS OF SOUTHWEST FLORIDA, INC
Provider Business Mailing Address
First Line : 350 BRADEN AVE
Second Line :
City : SARASOTA
State : FL
Zip : 34243-2001
Country : US
Telephone Number : 941-355-7637
Fax Number :
Provider Business Practice Location Address
First Line : 350 BRADEN AVE
Second Line :
City : SARASOTA
State : FL
Zip : 34243-2001
Country : US
Telephone Number : 941-355-7637
Fax Number : 941-444-2271
Authorized Official
Title or Position : CEO
Name : TOM WATERS
Credential :
Telephone Number : 941-355-7637
Provider Enumeration Date : 01/25/2007
Last Update Date : 05/18/2025

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Directions to “EASTERSEALS OF SOUTHWEST FLORIDA, INC ” Practice Location

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