Individual
IVAN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15681 N US HIGHWAY 301, CITRA, FL 32113-3154
(352) 595-5000
(352) 595-8431
Mailing address
6025 SE 46TH AVENUE RD, OCALA, FL 34480-7765
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ADC-006927-2015
FL
Other
Enumeration date
04/24/2017
Last updated
04/24/2017
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