Organization
IRECOVERY, LLC
Active
Organization
IRECOVERY, LLC
Active
Parent organization
IRECOVERY, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
IRECOVERY, LLC
Authorized official
MILDRED CINTRON (CREDENTIALING SPECIALIST)
(561) 235-7683
Entity
Organization
Contact information
Practice address
130 S INDIAN RIVER DR STE 202-6405, FORT PIERCE, FL 34950-4343
(772) 773-6989
(561) 464-5501
Mailing address
5030 CHAMPION BLVD STE G11-535, BOCA RATON, FL 33496-2473
(561) 235-7683
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1107100606
—
FL
Enumeration date
07/21/2021
Last updated
09/27/2021
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