Organization
HEART 2 HEART FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOLLICIA GREEN APRN (PRESIDENT)
(386) 916-0313
Entity
Organization
Contact information
Practice address
1326 STATE ROAD 100, MELROSE, FL 32666-3701
(386) 659-2104
Mailing address
1326 STATE ROAD 100, MELROSE, FL 32666-3701
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110545600
—
FL
Enumeration date
06/08/2020
Last updated
12/06/2022
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