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General NPI Number Information
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NPI Number | 1427367911
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Entity Type | Organization
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Legal Business Name | NORTH FL REGIONAL THYROID
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Dates
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Enumeration Date | 09/30/2010
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Last Update Date | 09/30/2010
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Provider Practice Location Address
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Address Line | 1705 S ADAMS ST
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City | TALLAHASSEE
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State | FL
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Zip | 32301-5406
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Country | US
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Telephone | 850-224-7154
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Fax | 850-224-3774
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Provider Business Mailing Address
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Address Line | 1705 S ADAMS ST
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City | TALLAHASSEE
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State | FL
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Zip | 32301-5406
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Country | US
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Telephone | 850-224-7154
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Fax | 850-224-3774
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Authorized Official
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Title or Position | OWNER
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Name | DR. CELESTE B HART
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Credential | M.D.
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Telephone | 850-224-7154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME57643
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License Number State | FL
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