Organization · NPI-2

Treasure Coast Neuroscience And Wellness Center LLC

Psychiatry & Neurology, Neurology · Fort Pierce, FL

NPI number1093242844
StatusActive
Last updated in NPPESJul 21, 2022

Details

NPI
1093242844
Entity type
Organization (NPI-2)
Legal business name
Treasure Coast Neuroscience And Wellness Center LLC
Organization subpart
No
Enumeration date
May 11, 2017
Last updated
Jul 21, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084N0400X Psychiatry & Neurology, NeurologyME131849FLYes

Practice location

1701 S 23rd St
Fort Pierce, FL 34950-4804

Phone 772-448-8600

Mailing address

1701 S 23rd St
Fort Pierce, FL 34950-4804

Phone 772-448-8600

Authorized official

Tariq Gheith
Owner
7088562338

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