Organization
COASTAL CARE TAMPA BAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS VICTORIA PETTOGRASSO (PRESIDENT)
(941) 306-1991
Entity
Organization
Contact information
Practice address
340 TAMIAMI TRL S, STE 203, NOKOMIS, FL 34275-3179
(941) 306-1991
Mailing address
9040 TOWN CENTER PKWY, 106A, LAKEWOOD RANCH, FL 34202-4101
(941) 306-1991
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
30211572
FL
253Z00000X
In Home Supportive Care Agency
—
FL
Other
Enumeration date
06/27/2012
Last updated
07/21/2022
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