Organization
K A COMPREHENSIVE MEDICAL AND PSYCHIATRIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ACELISE ALEXIS FNP (CEO)
(561) 410-4180
Entity
Organization
Contact information
Practice address
6801 LAKE WORTH RD STE 219, GREENACRES, FL 33467-2966
(561) 328-8420
(561) 828-2884
Mailing address
6801 LAKE WORTH RD STE 219, GREENACRES, FL 33467-2966
(561) 328-8420
(561) 828-2884
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN9203914
BLUE CROSS BLUE SHEILD, SUNSHINE, MEDICARE, UHC, AETNA, CIGNA
FL
Enumeration date
01/17/2020
Last updated
08/02/2022
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