Organization
WEST COAST AIDS FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT W LAARTZ MD (PRESIDENT)
(727) 669-6800
Entity
Organization
Contact information
Practice address
8607 EASTHAVEN COURT, SUITE 101, NEW PORT RICHEY, FL 34655-5217
(727) 669-6800
Mailing address
1840 MEASE DRIVE, SUITE 319, SAFETY HARBOR, FL 34695-6605
(727) 669-6800
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
6817831-00
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6932118-00
—
FL
Enumeration date
05/29/2008
Last updated
05/29/2008
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