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Organization
GULF COAST MED CTR PHYSICAL THERAPY
Active
Organization
GULF COAST MED CTR PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI BRIENZA RN, LHRM, CCS-P (FACILITIES DIRECTOR)
(727) 868-2151
Entity
Organization
Contact information
Practice address
11528 US HIGHWAY 19, PORT RICHEY, FL 34668-1442
(727) 861-4770
(727) 861-3351
Mailing address
11528 US HIGHWAY 19, PORT RICHEY, FL 34668-1442
(727) 861-4770
(727) 861-3351
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
225100000X
Physical Therapist
Primary
—
—
225700000X
Massage Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01589
UNIVERSAL HEALTH CARE
FL
01
—
DE6703
RAILROAD MEDICARE
FL
Enumeration date
02/24/2006
Last updated
08/27/2012
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