Provider Demographics
NPI:1770222069
Name:GULF COAST PELVIC HEALTH LLC
Entity type:Organization
Organization Name:GULF COAST PELVIC HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAYDEE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:ZIMMERN
Authorized Official - Suffix:
Authorized Official - Credentials:PT,DPT
Authorized Official - Phone:850-764-1092
Mailing Address - Street 1:210 E INTENDENCIA ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-6023
Mailing Address - Country:US
Mailing Address - Phone:850-764-1092
Mailing Address - Fax:850-546-6280
Practice Address - Street 1:210 E INTENDENCIA ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-6023
Practice Address - Country:US
Practice Address - Phone:850-764-1092
Practice Address - Fax:850-546-6280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-03
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty