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NPI Code Detail

MEDICARE: GULF COAST REHABILITATION AND WELLNESS CENTER INC

MEDICARE: GULF COAST REHABILITATION AND WELLNESS CENTER 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
1363LF0000XFamily Nurse Practitioner
2111N00000XChiropractor

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 : 1922297977
Entity Type Code : Organization
Provider Name (Legal Business Name) : GULF COAST REHABILITATION AND WELLNESS CENTER INC
Provider Business Mailing Address
First Line : 6250 PARK BLVD
Second Line :
City : PINELLAS PARK
State : FL
Zip : 33781-3237
Country : US
Telephone Number : 727-541-2520
Fax Number : 727-544-8971
Provider Business Practice Location Address
First Line : 6250 PARK BLVD
Second Line :
City : PINELLAS PARK
State : FL
Zip : 33781-3237
Country : US
Telephone Number : 727-541-2520
Fax Number : 727-544-8971
Authorized Official
Title or Position : CHIROPRACTOR
Name : DR. KEVIN RONALD LEE
Credential : D.C.
Telephone Number : 727-541-2520
Provider Enumeration Date : 10/16/2007
Last Update Date : 05/23/2023

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Directions to “GULF COAST REHABILITATION AND WELLNESS CENTER INC ” Practice Location

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