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General NPI Number Information
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NPI Number | 1326587668
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Entity Type | Organization
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Legal Business Name | MULTIDISCIPLINARY CENTER
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Dates
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Enumeration Date | 02/20/2017
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 715 W GAINES STREET
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City | TALLAHASSEE
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State | FL
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Zip | 32308
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Country | US
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Telephone | 850-644-9920
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Fax |
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Provider Business Mailing Address
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Address Line | 715 W GAINES STREET
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City | TALLAHASSEE
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State | FL
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Zip | 32308
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSITANT DIRECTOR
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Name | JOANN MILFORD
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Credential | M.S.
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Telephone | 850-644-9920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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