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1315 Country Club Rd Gulf Breeze FL 32563-3451 | |
| (850) 776-6619 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1315 Country Club Rd, Gulf Breeze, Florida |
| Authorized Official Name and Position | Nicole Bero (OWNER) |
| Authorized Official Contact | 8507766619 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5420 Gulf Breeze Pkwy Gulf Breeze FL 32563-9302 Ph: (850) 776-6619 | 1315 Country Club Rd Gulf Breeze FL 32563-3451 Ph: (850) 776-6619 |
| NPI Number | 1487381901 |
|---|---|
| Provider Enumeration Date | 08/04/2022 |
| Last Update Date | 07/03/2023 |
| Certification Date | 07/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487381901 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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