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Organization

CARL C. GITTENS MD PA

Active
Other names
Carl C. Gittens MD PA
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CARL C. GITTENS M.D. (PRESIDENT)
(772) 215-5905
Entity
Organization

Contact information

Practice address
789 SW FEDERAL HWY, SUITE 212, STUART, FL 34994-2962
(772) 215-5905
Mailing address
789 SW FEDERAL HWY, SUITE 212, STUART, FL 34994-2962

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
ME53378
FL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
ME53378
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ME53378
LICENSE NUMBER
FL
Enumeration date
10/20/2014
Last updated
08/02/2017
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