| NPI | 1063919637 |
|---|---|
| Doing Business As | BEACHSIDE |
| Entity Type | Organization |
| Authorized Contact | MELISSA GAD Manager 386-262-5197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP9355262) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2018-04-10 |