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General NPI Number Information
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NPI Number | 1548791494
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Entity Type | Organization
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Legal Business Name | THE RECOVERY RESEARCH NETWORK
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Dates
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Enumeration Date | 03/22/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 110 JFK DR BLD B, UNIT 5, SUITE. 118
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City | ATLANTIS
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State | FL
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Zip | 33462
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Country | US
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Telephone | 561-812-2000
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Fax | 561-423-0822
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Provider Business Mailing Address
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Address Line | 110 JFK DR BLD B, UNIT 5, SUITE. 118
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City | ATLANTIS
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State | FL
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Zip | 33462-1146
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Country | US
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Telephone | 561-812-2000
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MS. GENA GUSTIN
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Credential |
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Telephone | 516-812-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | 5001
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | 1009309
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License Number State | FL
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