| Reclamation Center | |
|
2900 W Cypress Creek Rd Ste 13 Fort Lauderdale FL 33309-1715 | |
| (954) 343-6552 | |
| (754) 255-7455 |
| Full Name | Reclamation Center |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2900 W Cypress Creek Rd Ste 13, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Adderly Tibo (OWNER) |
| Authorized Official Contact | 9546148755 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reclamation Center 2900 W Cypress Creek Rd Ste 13 Fort Lauderdale FL 33309-1715 Ph: (954) 343-6552 | Reclamation Center 2900 W Cypress Creek Rd Ste 13 Fort Lauderdale FL 33309-1715 Ph: (954) 343-6552 |
| NPI Number | 1598360562 |
|---|---|
| Provider Enumeration Date | 11/30/2020 |
| Last Update Date | 07/02/2024 |
| Certification Date | 07/02/2024 |
| Medicare PECOS PAC ID | 4385022979 |
|---|---|
| Medicare Enrollment ID | O20220610000890 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598360562 | NPI | - | NPPES |
| 109377800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Pierre E Pean |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710013990 PECOS PAC ID: 9931367596 Enrollment ID: I20120228000693 |
| Provider Name | Martine Vedrine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366834970 PECOS PAC ID: 8325350564 Enrollment ID: I20160224002486 |
| Provider Name | Jossener Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003355710 PECOS PAC ID: 8921364589 Enrollment ID: I20171114003376 |
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