Provider Demographics
NPI:1295569895
Name:TRASCIENDE PROFESSIONAL GROUP LLC
Entity type:Organization
Organization Name:TRASCIENDE PROFESSIONAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBR
Authorized Official - Prefix:
Authorized Official - First Name:GEHISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:862-300-6996
Mailing Address - Street 1:932 E OSCEOLA PKWY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-1615
Mailing Address - Country:US
Mailing Address - Phone:407-536-7114
Mailing Address - Fax:
Practice Address - Street 1:932 E OSCEOLA PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-1615
Practice Address - Country:US
Practice Address - Phone:407-536-7114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health