Organization
DFDFDF
Active
Organization
DFDFDF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DFDFDFD DFD FDFDFDF MD (DOC)
(561) 412-2015
Entity
Organization
Contact information
Practice address
7156 COLONY CLUB DR, 309, LAKE WORTH, FL 33463-7836
(561) 420-5120
Mailing address
7156 COLONY CLUB DR, LAKE WORTH, FL 33463-7836
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
8666
FL
Other
Enumeration date
07/20/2010
Last updated
07/20/2010
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