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315 E. Olympia Avenue Suite 252 Punta Gorda FL 33950-3823 | |
| (941) 637-7111 | |
| (941) 637-7343 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 315 E. Olympia Avenue, Punta Gorda, Florida |
| Authorized Official Name and Position | Cora S Taylor (DIRECTOR, OWNER) |
| Authorized Official Contact | 9416377111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
315 E. Olympia Avenue Suite 252 Punta Gorda FL 33950-3823 Ph: (941) 637-7111 | 315 E. Olympia Avenue Suite 252 Punta Gorda FL 33950-3823 Ph: (941) 637-7111 |
| NPI Number | 1528331477 |
|---|---|
| Provider Enumeration Date | 02/22/2012 |
| Last Update Date | 01/15/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528331477 | NPI | - | NPPES |
| 677796196 | Medicaid | FL | |
| Z8690 | Other | FL | BLUE CROSS BLUE SHIELD OF FLORIDA |
| 254891 | Other | FL | VALUE OPTIONS |
| 7683064 | Other | FL | AETNA |
| 11336 | Other | FL | COMPCARE |
| 89541739 | Other | FL | UNITED BEHAVIORAL HEALTH |
| CTAYLOR19 | Other | FL | CIGNA |
| 280650 | Other | FL | WELLCARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MH4605 (Florida) | Primary |
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