Provider Demographics
NPI:1043535362
Name:QUALITY PROFESSIONALS,INC
Entity type:Organization
Organization Name:QUALITY PROFESSIONALS,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GAVIN-ZOSKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-756-3399
Mailing Address - Street 1:2172 S RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH DAYTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32119-3070
Mailing Address - Country:US
Mailing Address - Phone:386-756-3399
Mailing Address - Fax:386-322-0595
Practice Address - Street 1:2172 S RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-3070
Practice Address - Country:US
Practice Address - Phone:386-756-3399
Practice Address - Fax:386-322-0595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992147251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299992147OtherHOME HEALTH CARE AGENCY