Organization
BAIM OF GILEAD HEALTHCARE SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BYRON DEMETRUIS ROQUEMORE MOML,CAP,CCJAP (CONSULTANT)
(813) 443-5028
Entity
Organization
Contact information
Practice address
9804 N 26TH ST, TAMPA, FL 33612-8420
(813) 443-5028
Mailing address
9804 N 26TH STREET, TAMPA, FL 33612
(813) 443-5028
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
FL
Other
Enumeration date
07/16/2013
Last updated
07/16/2013
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