| Organization Name: | GULF COAST THERAPY ASSOCIATES, P.A. |
| NPI Number: | 1023227436 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THEESA C BENOCK (OCCUPATIONAL THERAPIST) |
| Mailing Address: | 3417 Tamiami Trl Ste A Port Charlotte |
| State: | FL US |
| Postal Code: | 339528158 |
| Phone Number: | 9416246222 |
| Fax Number: | 9416246831 |
| NPI Enumeration Date: | 05/22/2007 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | OT1055 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |