Provider Demographics
NPI:1730646605
Name:GULF BREEZE HOME HEALTH, INC.
Entity Type:Organization
Organization Name:GULF BREEZE HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MS
Authorized Official - First Name:LIDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-281-8400
Mailing Address - Street 1:111 2ND AVE N STE 355
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3315
Mailing Address - Country:US
Mailing Address - Phone:727-623-0394
Mailing Address - Fax:727-623-0398
Practice Address - Street 1:111 2ND AVE N STE 355
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3315
Practice Address - Country:US
Practice Address - Phone:727-623-0394
Practice Address - Fax:727-623-0398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health