Organization
TED SLONE,LLC
Active
Other names
Sugarmill Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN GOODPASTER (MANAGING PARTNER)
(352) 795-6929
Entity
Organization
Contact information
Practice address
8303 S SUNCOAST BLVD, HOMOSASSA, FL 34446-5028
(352) 795-6929
(352) 794-5086
Mailing address
1122 SE KINGS BAY DR, CRYSTAL RIVER, FL 34429-4645
(352) 795-6929
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267384300
—
FL
05
—
291921400
—
FL
01
—
V3150
BLUE CROSS
—
Enumeration date
08/26/2008
Last updated
08/26/2008
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