Organization
APD - TACACHALE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DON E THOMAS (SUPERINTENDENT)
(352) 955-5856
Entity
Organization
Contact information
Practice address
1621 NE WALDO RD, GAINESVILLE, FL 32609-3900
(352) 955-5884
Mailing address
1621 NE WALDO RD, GAINESVILLE, FL 32609-3900
(352) 955-5668
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT18456
FL
225200000X
Physical Therapy Assistant
PTA16188
FL
225X00000X
Occupational Therapist
Primary
OT2972
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
681084596
—
FL
Enumeration date
04/02/2009
Last updated
04/02/2009
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