Organization
BREAKTHROUGH ECLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHALIE GRANT APRN (MANAGER)
(352) 325-7884
Entity
Organization
Contact information
Practice address
6019 W RIO GRANDE DR, BEVERLY HILLS, FL 34465-2016
(523) 257-8843
Mailing address
6019 W RIO GRANDE DR, BEVERLY HILLS, FL 34465-2016
(523) 257-8843
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
08/14/2023
Last updated
10/13/2023
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