Organization
HEALTHSTAT WELLNESS PASCO DADE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL JOHNSON PATTON (DIRECTOR OF RISK MANAGEMENT)
(704) 936-5546
Entity
Organization
Contact information
Practice address
36739 STATE ROAD 52, SUITE 104, DADE CITY, FL 33525-5101
(704) 529-6161
Mailing address
4651 CHARLOTTE PARK DR, SUITE 300, CHARLOTTE, NC 28217-1956
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
—
—
Other
Enumeration date
10/07/2014
Last updated
08/17/2020
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