# BREAKTHROUGH ECLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902589146
- **Authorized official:** NATHALIE GRANT APRN (MANAGER)
- **Authorized official phone:** (352) 325-7884

## Contact information

- **Practice address:** 6019 W RIO GRANDE DR, BEVERLY HILLS, FL 34465-2016
- **Practice address phone:** (523) 257-8843
- **Mailing address:** 6019 W RIO GRANDE DR, BEVERLY HILLS, FL 34465-2016
- **Mailing address phone:** (523) 257-8843

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 08/14/2023
- **Last updated:** 10/13/2023