Organization
ADDICTION DOCTOR OF THE PALM BEACHES
Active
Other names
Carl C. Gittens MD PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL C. GITTENS SR. M.D. (PRESIDENT)
(772) 215-5905
Entity
Organization
Contact information
Practice address
789 SW FEDERAL HWY STE 212, STUART, FL 34994-2962
(772) 215-5905
(772) 905-3336
Mailing address
789 SW FEDERAL HWY STE 212, STUART, FL 34994-2962
(772) 215-5905
(772) 905-3336
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
ME53378
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME53378
LICENSE NUMBER
FL
Enumeration date
10/22/2014
Last updated
04/14/2015
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