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7441 114th Ave Ste 604 Largo FL 33773-5124 | |
| (727) 492-5369 | |
| (727) 350-3255 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 7441 114th Ave Ste 604, Largo, Florida |
| Authorized Official Name and Position | David Engelman (PRESIDENT) |
| Authorized Official Contact | 7274921253 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
7441 114th Ave Ste 604 Largo FL 33773-5124 Ph: (727) 492-5369 | 7441 114th Ave Ste 604 Largo FL 33773-5124 Ph: (727) 492-5369 |
| NPI Number | 1659345650 |
|---|---|
| Provider Enumeration Date | 02/15/2006 |
| Last Update Date | 03/30/2022 |
| Certification Date | 03/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659345650 | NPI | - | NPPES |
| 017455400 | Medicaid | FL | |
| 017455401 | Medicaid | FL | |
| 689077696 | Medicaid | FL |
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