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997 Atlantic Blvd Atlantic Beach FL 32233-3311 | |
| (904) 647-1849 | |
| (904) 647-2625 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 997 Atlantic Blvd, Atlantic Beach, Florida |
| Authorized Official Name and Position | Genevieve Hickey Covington (CEO) |
| Authorized Official Contact | 9046471849 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
997 Atlantic Blvd Atlantic Beach FL 32233-3311 Ph: (904) 647-1849 | 997 Atlantic Blvd Atlantic Beach FL 32233-3311 Ph: (904) 647-1849 |
| NPI Number | 1780088609 |
|---|---|
| Provider Enumeration Date | 10/21/2014 |
| Last Update Date | 01/16/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780088609 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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