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256 Canal Street Port Saint Joe FL 32456 | |
(850) 273-8450 | |
(423) 803-4776 |
Full Name | |
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Speciality | Clinic/center |
Location | 256 Canal Street, Port Saint Joe, Florida |
Authorized Official Name and Position | Patricia Mitchell (OWNER/FOUNDER) |
Authorized Official Contact | 8502738450 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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101 S 23rd St Mexico Beach FL 32456-7178 Ph: (850) 273-8450 | 256 Canal Street Port Saint Joe FL 32456 Ph: (850) 273-8450 |
NPI Number | 1710583190 |
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Provider Enumeration Date | 12/10/2020 |
Last Update Date | 03/18/2021 |
Identifier | Type | State | Issuer |
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1710583190 | NPI | - | NPPES |
MC1F7 | Other | FLORIDA BLUE |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |