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Organization

COTG 2021

Active
Other names
COVID ON THE GO
Organization subpart
No

Provider details

NPI number
Authorized official
FELICIA PRINCE (DIRECTOR)
(321) 327-7481
Entity
Organization

Contact information

Practice address
1385 CYPRESS AVE UNIT 104, MELBOURNE, FL 32935-5919
(321) 327-7481
(888) 453-1715
Mailing address
1220 PROSPECT AVE STE 294, MELBOURNE, FL 32901-7300
(772) 300-6531

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
251S00000X
Community/Behavioral Health Agency
261QC1500X
Community Health Clinic/Center
261QX0100X
Occupational Medicine Clinic/Center
291U00000X
Clinical Medical Laboratory
Primary

Other

Enumeration date
04/16/2021
Last updated
01/09/2024
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