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710 Oakfield Dr Brandon FL 33511-4938 | |
| (813) 445-8575 | |
| (813) 649-8085 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 710 Oakfield Dr, Brandon, Florida |
| Authorized Official Name and Position | Nickeisha K Clarke (PROVIDER) |
| Authorized Official Contact | 8134458575 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
710 Oakfield Dr Ste 153 Brandon FL 33511-4954 Ph: (813) 445-8575 | 710 Oakfield Dr Brandon FL 33511-4938 Ph: (813) 445-8575 |
| NPI Number | 1063054310 |
|---|---|
| Provider Enumeration Date | 10/08/2019 |
| Last Update Date | 11/08/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063054310 | NPI | - | NPPES |
| 1245710904 | Other | FL | NPI |
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