Provider Demographics
NPI:1295111201
Name:GAVIOTA CARE INC
Entity type:Organization
Organization Name:GAVIOTA CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-285-1392
Mailing Address - Street 1:2461 EVERGLADES BLVD N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-5540
Mailing Address - Country:US
Mailing Address - Phone:239-285-1392
Mailing Address - Fax:941-462-1868
Practice Address - Street 1:2461 EVERGLADES BLVD N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-5540
Practice Address - Country:US
Practice Address - Phone:239-285-1392
Practice Address - Fax:941-462-1868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No251E00000XAgenciesHome Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)