Organization
EXCEPTIONAL CARE CHOICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUSTI LABATTE-DENEAU ARNP (NURSE PRACTITIONER)
(772) 333-9319
Entity
Organization
Contact information
Practice address
1632 SW IVY ST, PORT ST LUCIE, FL 34987-2248
(917) 207-4785
Mailing address
1632 SW IVY ST, PORT ST LUCIE, FL 34987-2248
(917) 207-4785
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP9263802
FL
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016402900
—
FL
Enumeration date
05/06/2015
Last updated
10/02/2017
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