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Organization

PEDIATRIC ALTERNATIVE TREATMENT CARE, HOUSING & EVALUATION SERVICES

Active
Other names
PATCHES
Organization subpart
No

Provider details

NPI number
Authorized official
MS. AZONA KYLE SMITH RN, BSN (ADMINISTRATOR)
(305) 242-8122
Entity
Organization

Contact information

Practice address
4300 OKEECHOBEE RD, FORT PIERCE, FL 34947-5407
(772) 462-6601
Mailing address
335 S KROME AVE, SUITE 104, FLORIDA CITY, FL 33034-4906
(305) 242-8122

Taxonomy

Speciality
Code
Description
License number
State
2279G1100X
General Care Registered Respiratory Therapist
Primary
891891900
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
891861900
FL
Enumeration date
06/11/2008
Last updated
09/11/2019
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