Organization
BRAIN TRAINING CENTER OF THE TREASURE COAST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA MELAINE RANKIN M.D. (PRESIDENT)
(772) 408-0096
Entity
Organization
Contact information
Practice address
499 NW PRIMA VISTA BLVD, SUITE 101, PORT SAINT LUCIE, FL 34983-8786
(772) 408-0096
(772) 408-8167
Mailing address
499 NW PRIMA VISTA BLVD, SUITE 101, PORT SAINT LUCIE, FL 34983-8786
(772) 408-0096
(772) 408-8167
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
ME004325
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720012438
PERSONAL NPI
FL
Enumeration date
03/23/2010
Last updated
03/23/2010
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