| NPI | 1023791738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA A PRESCOTT Medical Director 772-584-3083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| 2084D0003X | |
| 2084P0301X Psychiatry & Neurology, Brain Injury Medicine | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2023-08-09 |