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NPI Code Detail

MEDICARE: ST. FRANCIS PATHWAYS TO HEALTHCARE, LLC

MEDICARE: ST. FRANCIS PATHWAYS TO HEALTHCARE, LLC
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
1207RH0002XHospice and Palliative Medicine (Internal Medicine) Physician

General Provider Information

NPI Number : 1639563422
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST. FRANCIS PATHWAYS TO HEALTHCARE, LLC
Provider Business Mailing Address
First Line : 1250 GRUMMAN PL STE B
Second Line :
City : TITUSVILLE
State : FL
Zip : 32780-7927
Country : US
Telephone Number : 321-269-4240
Fax Number :
Provider Business Practice Location Address
First Line : 1250 GRUMMAN PL STE B
Second Line :
City : TITUSVILLE
State : FL
Zip : 32780-7927
Country : US
Telephone Number : 321-269-4240
Fax Number :
Authorized Official
Title or Position : CHIEF COMPLIANCE OFFICER
Name : TAMMY ROLFE
Credential :
Telephone Number : 207-242-5386
Provider Enumeration Date : 03/19/2015
Last Update Date : 10/13/2021

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Directions to “ST. FRANCIS PATHWAYS TO HEALTHCARE, LLC ” Practice Location

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