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Organization
FAMILY AND PEDIATRIC CLINIC
Active
Organization
FAMILY AND PEDIATRIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETSY LISTON (OFFICE MANAGER)
(321) 784-5367
Entity
Organization
Contact information
Practice address
3000 N ATLANTIC AVE, SUITE 102, COCOA BEACH, FL 32931-5078
(321) 784-5367
Mailing address
3000 N ATLANTIC AVE, SUITE 102, COCOA BEACH, FL 32931-5078
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
IMH11652
FL
Other
Enumeration date
10/02/2014
Last updated
10/02/2014
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