Organization
IRECOVERY, LLC
Active
Parent organization
IRECOVERY, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
IRECOVERY, LLC
Authorized official
MILDRED CINTRON (CREDENTIALING SPECIALIST)
(561) 235-7683
Entity
Organization
Contact information
Practice address
301 W BAY ST STE 14208, JACKSONVILLE, FL 32202-5184
(904) 664-1454
(561) 464-5501
Mailing address
5030 CHAMPION BLVD STE G11-535, BOCA RATON, FL 33496-2473
(561) 235-7683
(561) 464-5501
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1107100605
—
FL
Enumeration date
07/21/2021
Last updated
09/27/2021
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