Organization
SPRINGBROOK HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS P MCAVOY (CFO)
(352) 597-5075
Entity
Organization
Contact information
Practice address
13406 CORTEZ BLVD, BROOKSVILLE, FL 34613-6822
(352) 597-5075
(352) 597-9644
Mailing address
7007 GROVE RD, BROOKSVILLE, FL 34609-8610
(352) 597-5075
(352) 597-9644
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30418
BCBS
FL
01
—
32507
BCBS
FL
Enumeration date
10/02/2007
Last updated
10/02/2007
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