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Cereus Osteopathic Medicine LLC

Clinic/Center, Medical Specialty in Cocoa, FL. Organization (NPI-2).

NPI number1336767680
StatusActive
Last updated in NPPESJul 13, 2020

Details

NPI
1336767680
Entity type
Organization (NPI-2)
Legal business name
Cereus Osteopathic Medicine LLC
Organization subpart
No
Enumeration date
Jul 13, 2020
Certification date
Jul 13, 2020
Last updated
Jul 13, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM2500X Clinic/Center, Medical Specialty––Yes

Practice location

870 N Cocoa Blvd Ste A
Cocoa, FL 32922-7588

Phone 321-866-8847 · Fax 954-351-8349

Mailing address

870 N Cocoa Blvd Ste A
Cocoa, FL 32922-7588

Phone 321-866-8847 · Fax 954-351-8349

Authorized official

Amy Joy Selwach
Sole Member
9542574262

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