Provider Demographics
NPI:1548049455
Name:START CARE PPEC
Entity type:Organization
Organization Name:START CARE PPEC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN CRUZ
Authorized Official - Middle Name:
Authorized Official - Last Name:LASSALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-461-5784
Mailing Address - Street 1:3991 PALAU DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34241-5842
Mailing Address - Country:US
Mailing Address - Phone:786-461-5784
Mailing Address - Fax:
Practice Address - Street 1:1945 NORTHGATE BLVD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-2143
Practice Address - Country:US
Practice Address - Phone:786-461-5784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-28
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty