|
| |
|
1000 36th St Vero Beach FL 32960-4862 | |
| (772) 567-4311 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 1000 36th St, Vero Beach, Florida |
| Authorized Official Name and Position | Timothy L. Longville (CAO / CONTROLLER) |
| Authorized Official Contact | 2166367416 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1000 36th St Vero Beach FL 32960-4862 Ph: (772) 567-4311 | 1000 36th St Vero Beach FL 32960-4862 Ph: (772) 567-4311 |
| NPI Number | 1376512988 |
|---|---|
| Provider Enumeration Date | 03/16/2006 |
| Last Update Date | 02/01/2023 |
| Certification Date | 02/01/2023 |
| Medicare PECOS PAC ID | 2365332632 |
|---|---|
| Medicare Enrollment ID | O20080219000494 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376512988 | NPI | - | NPPES |
| 309 | Other | FL | BLUE CROSS |
| 010104400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 4029 (Florida) | Secondary |
| 282N00000X | General Acute Care Hospital | 4029 (Florida) | Primary |
Fred J Petrilla Jr Phd & Associates Pa Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1903 25th St, Vero Beach, FL 32960 Phone: 772-562-0777 Fax: 772-770-3285 | |
Mending Pieces, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 21st St Ste 300, Vero Beach, FL 32960 Phone: 772-584-5650 | |
Vero Beach Neurology And Research Institute Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1040 37th Pl, Suite 201, Vero Beach, FL 32960 Phone: 772-492-7051 | |
Ibelieve Maternal Wellness & Counseling Center, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 21st St Ste 300, Vero Beach, FL 32960 Phone: 772-778-4246 | |
Vero Beach Cognitive Center Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 333 17th St Ste M, Vero Beach, FL 32960 Phone: 772-584-3083 Fax: 772-218-3003 | |
Center For Mood Disorders Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1408 19th St, Suite C, Vero Beach, FL 32960 Phone: 772-224-1294 | |
Refa Na Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2706 20th St, Vero Beach, FL 32960 Phone: 772-999-1977 Fax: 772-237-1962 |