Organization
COMMUNITY E.A.R.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL S. PASTORELLO (PROGRAM MANAGER, CSC)
(904) 725-9785
Entity
Organization
Contact information
Practice address
4320 DEERWOOD LAKE PARKWAY, SUITE 101-307, JACKSONVILLE, FL 32216
(904) 396-5702
(904) 725-9785
Mailing address
4320 DEERWOOD LAKE PARKWAY, SUITE 101-307, JACKSONVILLE, FL 32216
(904) 396-5702
(904) 725-9785
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
686732401
—
FL
01
—
686732479
AHCA
FL
01
—
687409600
DOEA / AHCA
FL
Enumeration date
10/03/2008
Last updated
03/05/2011
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