| Baybrooke Center Llc | |
|
4995 49th St N St Petersburg FL 33709 | |
| (727) 827-7890 | |
| (727) 279-4631 |
| Full Name | Baybrooke Center Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4995 49th St N, St Petersburg, Florida |
| Authorized Official Name and Position | Ronda Sue Miller (PRESIDENT) |
| Authorized Official Contact | 7278277890 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Baybrooke Center Llc 4995 49th St N St Petersburg FL 33709 Ph: (727) 827-7890 | Baybrooke Center Llc 4995 49th St N St Petersburg FL 33709 Ph: (727) 827-7890 |
| NPI Number | 1457749145 |
|---|---|
| Provider Enumeration Date | 01/02/2015 |
| Last Update Date | 12/11/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457749145 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH13006 (Florida) | Primary |
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