MEDICARE: METRO TREATMENT OF FLORIDA, LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	1006AD121903	FL
2	3336C0002X	Clinic Pharmacy	PH 19781	FL
3	261QM2800X	Methadone Clinic

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417163957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METRO TREATMENT OF FLORIDA, LP

Provider Business Mailing Address
First Line	:	2500 MAITLAND CENTER PARKWAY
Second Line	:	STE. 250
City	:	MAITLAND
State	:	FL
Zip	:	32751-4174
Country	:	US
Telephone Number	:	407-351-7080
Fax Number	:	407-351-6930

Provider Business Practice Location Address
First Line	:	2175 N. UNIVERSITY DRIVE
Second Line	:	STE. 7
City	:	SUNRISE
State	:	FL
Zip	:	33322-3938
Country	:	US
Telephone Number	:	954-578-7684
Fax Number	:	954-578-7689

Authorized Official
Title or Position	:	CFO
Name	:	MARIA JACKSON
Credential	:
Telephone Number	:	407-351-7080

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	11/04/2022

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