| West Eastern Health | |
|
4210 Valley Ridge Blvd Ste 101 Ponte Vedra Beach FL 32081-5171 | |
| (904) 593-8480 | |
| (904) 593-7980 |
| Full Name | West Eastern Health |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4210 Valley Ridge Blvd Ste 101, Ponte Vedra Beach, Florida |
| Authorized Official Name and Position | Aneel Paulus (CEO) |
| Authorized Official Contact | 7162429565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Eastern Health 4210 Valley Ridge Blvd Ste 101 Ponte Vedra Beach FL 32081-5171 Ph: (904) 593-8480 | West Eastern Health 4210 Valley Ridge Blvd Ste 101 Ponte Vedra Beach FL 32081-5171 Ph: (904) 593-8480 |
| NPI Number | 1255149829 |
|---|---|
| Provider Enumeration Date | 12/27/2024 |
| Last Update Date | 01/02/2025 |
| Certification Date | 01/02/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255149829 | NPI | - | NPPES |
| 1245525781 | Other | FL | FLORIDA MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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