Organization
ASSURANURSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISAAC GOMEZ REXACH (ADMINISTRATOR)
(727) 546-4861
Entity
Organization
Contact information
Practice address
5030 78TH AVE N STE 11, PINELLAS PARK, FL 33781-2406
(727) 546-4861
(800) 713-8330
Mailing address
5030 78TH AVE N STE 11, PINELLAS PARK, FL 33781-2406
(727) 546-4861
(800) 713-8330
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30212079
AHCA LICENSED NURSE REGISTRY
FL
Enumeration date
04/03/2020
Last updated
04/07/2020
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