Organization
HEALTHCARE STRAIGHT UP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY GOBLE (CEO)
(813) 417-0505
Entity
Organization
Contact information
Practice address
840 NEWBERGER RD, LUTZ, FL 33549-4024
(727) 824-0989
Mailing address
7661 FOUNTAIN AVE APT 2, LOS ANGELES, CA 90046-4028
(813) 417-0505
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
261QH0700X
Hearing and Speech Clinic/Center
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
06/21/2022
Last updated
06/21/2022
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