Tay Gaines Llc

NPI 1295991107 - Clinic/Center - 261QM0850X

NPI Details
NPI 1295991107
Enumeration Date 07/30/2008
Last Updated 09/02/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name TAY GARNETT TAY
Position PRESIDENT/MEMBER
Phone (561) 844-7699
Fax (561) 842-8215
Practice Location
4152 BLUE HERON BLVD W
SUITE 123
RIVIERA BEACH FL, 33404-4811, US
Phone (561) 844-7699
Fax (561) 842-8215
Business Location
4152 BLUE HERON BLVD W
SUITE 123
RIVIERA BEACH FL, 33404-4811, US
Phone (561) 844-7699
Fax (561) 842-8215
Toxanomy
Taxonomy Code 261QM0850X
License State Florida
License Number ME55707
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According to our database, Tay Gaines Llc NPI is 1295991107, taxonomy code is 261QM0850X and license number is ME55707, license state is located at Florida. Tay Gaines Llc physically located at 4152 Blue Heron Blvd W, Riviera Beach FL, 33404-4811. NPI Number 1033115704 has the healthcare provider type.

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1295991107 NPI number is provided on an as is basis without warranty of any kind. 1295991107 is maintained by the National Plan & Provider Enumeration System. The contents of Tay Gaines Llc are for informational purposes only.