| NPI | 1790189728 |
|---|---|
| Other Name | CARL C. GITTENS MD PA |
| Entity Type | Organization |
| Authorized Contact | CARL C. GITTENS President 772-215-5905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: FL me53378) |
| Additional Taxonomies | 251S00000X (Licence: FL ME53378) |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2017-08-02 |