Organization
COLONIAL MANAGEMENT GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS NELSON MASTERS (PROGRAM DIRECTOR)
(727) 544-0044
Entity
Organization
Contact information
Practice address
8800 49TH ST N STE 106, PINELLAS PARK, FL 33782-5332
(727) 544-0044
Mailing address
8800 49TH ST N STE 106, PINELLAS PARK, FL 33782-5332
(727) 544-0044
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
FL
Other
Enumeration date
04/17/2018
Last updated
04/17/2018
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