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13191 Starkey Rd Suite 14 Largo FL 33773-1400 | |
| (727) 586-6942 | |
| (727) 216-7692 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 13191 Starkey Rd, Largo, Florida |
| Authorized Official Name and Position | Wayne Alan Grosnick (PRESIDENT) |
| Authorized Official Contact | 7275866942 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
13191 Starkey Rd Suite 14 Largo FL 33773-1400 Ph: (727) 586-6942 | 13191 Starkey Rd Suite 14 Largo FL 33773-1400 Ph: (727) 586-6942 |
| NPI Number | 1194991729 |
|---|---|
| Provider Enumeration Date | 05/04/2008 |
| Last Update Date | 05/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194991729 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | SR-52-AD-823801 (Florida) | Primary |
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