Healthcare Provider Details

I. General information

NPI: 1316565187
Provider Name (Legal Business Name): AMERI CANN TREATMENT CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2020
Last Update Date: 09/06/2023
Certification Date: 08/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2177 SE OCEAN BLVD
STUART FL
34996-3305
US

IV. Provider business mailing address

2177 SE OCEAN BLVD
STUART FL
34996-3305
US

V. Phone/Fax

Practice location:
  • Phone: 772-281-1520
  • Fax: 772-210-5313
Mailing address:
  • Phone: 772-281-1520
  • Fax: 772-210-5313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEBBIE J STACEY
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 772-281-1520