Organization
WEST COAST AIDS FOUNDATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT W. LAARTZ MD (PRESIDENT)
(727) 669-6800
Entity
Organization
Contact information
Practice address
1840 MEASE DR, SUITE 319, SAFETY HARBOR, FL 34695-6602
(727) 669-6800
(727) 669-2540
Mailing address
1840 MEASE DR, SUITE 319, SAFETY HARBOR, FL 34695-6602
(727) 669-6800
(727) 669-2540
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
ME79021
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N07000008604
ARTICLES OF INCORPORATION
FL
Enumeration date
10/03/2007
Last updated
10/03/2007
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