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Organization

TAY GAINES LLC

Active
Other names
Tay Gaines MD
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TAY GARNETT GAINES M.D. (PRESIDENT/MEMBER)
(561) 844-7699
Entity
Organization

Contact information

Practice address
4152 BLUE HERON BLVD W, SUITE 123, RIVIERA BEACH, FL 33404-4811
(561) 844-7699
(561) 842-8215
Mailing address
4152 BLUE HERON BLVD W, SUITE 123, RIVIERA BEACH, FL 33404-4811
(561) 844-7699
(561) 842-8215

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
ME55707
FL

Other

Enumeration date
07/30/2008
Last updated
09/02/2008
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