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3550 N Goldenrod Rd Ste 1 Winter Park FL 32792-8823 | |
| (321) 441-1030 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3550 N Goldenrod Rd Ste 1, Winter Park, Florida |
| Authorized Official Name and Position | Anthony Mckeever (NATIONAL DIRECT OF AR) |
| Authorized Official Contact | 6105423064 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5850 T G Lee Blvd Ste 400 Orlando FL 32822-4409 Ph: (407) 362-9210 | 3550 N Goldenrod Rd Ste 1 Winter Park FL 32792-8823 Ph: (321) 441-1030 |
| NPI Number | 1134883358 |
|---|---|
| Provider Enumeration Date | 10/25/2021 |
| Last Update Date | 07/13/2022 |
| Certification Date | 07/13/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134883358 | NPI | - | NPPES |
| 029573624 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
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