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Organization
ANTIDOTE AI, LLC
Active
Organization
ANTIDOTE AI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROY WILLIAM PRILLAMAN III RRT, RN (OPERATIONS)
(786) 559-2723
Entity
Organization
Contact information
Practice address
4960 SW 72ND AVE, MIAMI, FL 33155-5544
(865) 592-7237
Mailing address
4960 SW 72ND AVE, MIAMI, FL 33155-5544
(865) 592-7237
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
NULL
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
251B00000X
Case Management Agency
—
NULL
261QC1500X
Community Health Clinic/Center
Primary
—
NULL
261QC1800X
Corporate Health Clinic/Center
—
NULL
261QR1300X
Rural Health Clinic/Center
—
NULL
261QU0200X
Urgent Care Clinic/Center
—
NULL
333300000X
Emergency Response System Companies
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
04/28/2022
Last updated
04/28/2022
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