| Ten Broeck Tennessee Physicians Group Inc | |
|
603 Main St Windermere FL 34786-3548 | |
| (407) 876-2200 | |
| (855) 420-5749 |
| Full Name | Ten Broeck Tennessee Physicians Group Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 603 Main St, Windermere, Florida |
| Authorized Official Name and Position | Glenda F Guy (DIRECTOR, COMPLIANCE) |
| Authorized Official Contact | 9316076513 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ten Broeck Tennessee Physicians Group Inc 603 Main St Windermere FL 34786-3548 Ph: (407) 876-2200 | Ten Broeck Tennessee Physicians Group Inc 603 Main St Windermere FL 34786-3548 Ph: (407) 876-2200 |
| NPI Number | 1417559006 |
|---|---|
| Provider Enumeration Date | 11/10/2020 |
| Last Update Date | 11/10/2020 |
| Certification Date | 11/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417559006 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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