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Organization
JUVENATE LLC
Active
Organization
JUVENATE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDI GAY (CREDENTIALING MANAGER)
(850) 248-2468
Entity
Organization
Contact information
Practice address
609 E 6TH CT, PANAMA CITY, FL 32401-3605
(850) 348-0293
Mailing address
609 E 6TH CT, PANAMA CITY, FL 32401-3605
(850) 348-0293
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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