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General NPI Number Information
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NPI Number | 1578451316
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Entity Type | Organization
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Legal Business Name | WEEKIDS PSYCHCARE
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Dates
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Enumeration Date | 06/27/2025
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 90 FORT WADE ROAD SUITE 100 #1072
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City | PONTE VEDRA
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State | FL
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Zip | 32081
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Country | US
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Telephone | 904-772-5689
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Fax |
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Provider Business Mailing Address
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Address Line | 90 FORT WADE ROAD SUITE 100 #1072
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City | PONTE VEDRA
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State | FL
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Zip | 32081
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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 | PRESIDENT
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Name | REBECCA BERTONE
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Credential | APRN
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Telephone | 904-772-5688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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