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Organization
LIFE SOLUTIONS OUTPATIENT CORP
Active
Organization
LIFE SOLUTIONS OUTPATIENT CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STAN KOTEI (ADMINISTRATOR)
(850) 583-5388
Entity
Organization
Contact information
Practice address
3111 MAHAN DR, SUITE 20 #113, TALLAHASSEE, FL 32308-5548
(850) 583-5388
Mailing address
1341 EAST TENNESSEE STREET, TALLAHASSEE, FL 32308
(850) 583-5388
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
02/16/2016
Last updated
02/16/2016
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