Provider Demographics
NPI:1487091781
Name:PASCAL, APOLD
Entity type:Individual
Prefix:
First Name:APOLD
Middle Name:
Last Name:PASCAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 POSADAS CIR
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33983-5848
Mailing Address - Country:US
Mailing Address - Phone:941-628-5099
Mailing Address - Fax:941-875-9007
Practice Address - Street 1:382 POSADAS CIR
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33983-5848
Practice Address - Country:US
Practice Address - Phone:941-628-5099
Practice Address - Fax:941-875-9007
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6906395311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home