| Restorative Biotherapy Pllc | |
|
1315 Valentine St Melbourne FL 32901-3127 | |
| (321) 626-0125 | |
| Not Available |
| Full Name | Restorative Biotherapy Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1315 Valentine St, Melbourne, Florida |
| Authorized Official Name and Position | Mark Mctammany (OWNER) |
| Authorized Official Contact | 3216260125 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restorative Biotherapy Pllc 1315 Valentine St Melbourne FL 32901-3127 Ph: (321) 626-0125 | Restorative Biotherapy Pllc 1315 Valentine St Melbourne FL 32901-3127 Ph: (321) 626-0125 |
| NPI Number | 1922691674 |
|---|---|
| Provider Enumeration Date | 02/13/2021 |
| Last Update Date | 02/13/2021 |
| Medicare PECOS PAC ID | 0648671131 |
|---|---|
| Medicare Enrollment ID | O20210622000386 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922691674 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Mark S Mctammany |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265434211 PECOS PAC ID: 0244225589 Enrollment ID: I20040416000977 |
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