12 Keys Medical Group Llc | |
618 Ne Jensen Beach Blvd Jensen Beach FL 34957-4750 | |
(772) 201-7892 | |
Not Available |
Full Name | 12 Keys Medical Group Llc |
---|---|
Speciality | Psychologist - Addiction (substance Use Disorder) |
Location | 618 Ne Jensen Beach Blvd, Jensen Beach, Florida |
Authorized Official Name and Position | Kevin D Lee (CEO) |
Authorized Official Contact | 6159733500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
12 Keys Medical Group Llc 618 Ne Jensen Beach Blvd Jensen Beach FL 34957-4750 Ph: () - | 12 Keys Medical Group Llc 618 Ne Jensen Beach Blvd Jensen Beach FL 34957-4750 Ph: (772) 201-7892 |
NPI Number | 1750738589 |
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Provider Enumeration Date | 05/23/2016 |
Last Update Date | 05/23/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750738589 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TA0400X | Psychologist - Addiction (substance Use Disorder) | ME83027 (Florida) | Primary |
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