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Organization

REVAMED CLEWISTON

Active
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Organization

REVAMED CLEWISTON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NATHALIE BASTIEN-MONTPEIROUS M.D. (MEDICAL DIRECTOR)
(863) 983-5453
Entity
Organization

Contact information

Practice address
406 S DEANE DUFF AVE, CLEWISTON, FL 33440-3818
(863) 983-5453
Mailing address
406 S DEANE DUFF AVE, CLEWISTON, FL 33440-3818
(863) 983-5453

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
NULL
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL

Other

Enumeration date
05/19/2025
Last updated
05/19/2025
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