Organization
FCC COLEMAN
Active
Parent organization
BOP
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOP
Authorized official
IVAN NEGRON M.D. (COMPLEX CLINICAL DIRECTOR)
(352) 689-3018
Entity
Organization
Contact information
Practice address
846 NE 54TH TERRACE, COLEMAN, FL 33521-1029
(352) 689-3018
Mailing address
PO BOX 1029, COLEMAN, FL 33521-1029
(352) 689-3267
Taxonomy
Speciality
Code
Description
License number
State
261QP2400X
Prison Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/14/2009
Last updated
07/14/2009
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