Active NPI
Gulf Breeze Home Health, Inc.
- Home Health Agency
- St Petersburg, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- GULF BREEZE HOME HEALTH, INC.
- Practice address
- 111 2ND Ave N Ste 319
St Petersburg, FL 33701-3315 - Phone
- (727) 623-0394
- Fax
- (727) 623-0398
- NPI assigned
- Feb 26, 2019
- Last updated
- May 6, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Lidia Montero
- Title
- VP
- Phone
- (786) 281-8400
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | NU | Primary |
Addresses
Primary practice location
111 2ND Ave N Ste 319
St Petersburg, FL 33701-3315
Mailing address
111 2ND Ave N Ste 319
St Petersburg, FL 33701-3315
Phone (727) 623-0394
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190924001127 | FL | Part A Provider - Home Health Agency | 6406186147 | Practice locations: Saint Petersburg, FL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1730646605. Details of each certification follow.
Home health agency certification: CCN 687096
- Legal name
- GULF BREEZE HOME HEALTH, INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Mar 23, 2021
- Last certification
- Mar 23, 2021
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Dec 9, 2018 in FL
- Enrollment address
- 111 2ND Ave NE
Ste 355
Saint Petersburg, FL 33701-3465
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Gulf Breeze Home Health Inc
- Overall star rating
- Ownership
- Proprietary
- Certified
- Mar 23, 2021
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2165195 | Gulf Breeze Home Health, Inc | Certificate of waiver | Apr 22, 2027 |
National Provider Directory
National Provider DirectoryLocations
111 2nd Ave NE
Ste 355
Saint Petersburg, FL 33701
Phone (727) 623-0394
111 2nd Ave N
Ste 319
St Petersburg, FL 33701
Phone (727) 623-0394
111 2nd Ave N
Ste 355
St Petersburg, FL 33701
Ownership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Marc Green | 5% Or Greater Direct Ownership Interest | Dec 9, 2018 | 50% |
| Corporate Officer | Dec 9, 2018 | 50% | |
| Corporate Director | Dec 9, 2018 | 50% | |
| W-2 Managing Employee | Dec 9, 2018 | 50% | |
| Operational/Managerial Control | Dec 9, 2018 | 50% | |
| Lidia Montero | 5% Or Greater Direct Ownership Interest | Dec 9, 2018 | 50% |
| Corporate Officer | Dec 9, 2018 | 50% | |
| Corporate Director | Dec 9, 2018 | 50% | |
| W-2 Managing Employee | Dec 9, 2018 | 50% | |
| Operational/Managerial Control | Dec 9, 2018 | 50% |
Practitioners & affiliated clinicians
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Largo, FL
- NPI 1760460513
Home health agency
-
- Internal Medicine Physician
- St Petersburg, FL
- NPI 1053388512
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551139200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1778025600000",
"number": "1730646605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 2ND AVE N STE 319",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337013315",
"telephone_number": "727-623-0394",
"fax_number": "727-623-0398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 2ND AVE N STE 319",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337013315",
"telephone_number": "727-623-0394",
"fax_number": "727-623-0398"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GULF BREEZE HOME HEALTH, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2019-02-26",
"last_updated": "2026-05-06",
"certification_date": "2026-05-06",
"status": "A",
"authorized_official_last_name": "MONTERO",
"authorized_official_first_name": "LIDIA",
"authorized_official_title_or_position": "VP",
"authorized_official_telephone_number": "786-281-8400",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St Petersburg, FL
- Francois Guimond, MD
- Deniz Basak Gul, RMFTI
- Yukti Gulati, D.D.S
- Gulf Aviation Services II, LLC (EMS Air)
- Gulf Aviation Services, LLC (emsAir)
- Gulf Coast Family Wellness LLC
- Gulf Coast Internist, LLC.
- Gulf Coast Jewish Family Services (66TH Street Group Home)
- Gulf Coast Psychiatry PLLC
- Gulf-to-Bay Anesthesiology Associates LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.