| Cgr Beacon Clinic, Pa | |
|
3782 Tamiami Trl Port Charlotte FL 33952-8353 | |
| (941) 629-7855 | |
| (941) 629-9589 |
| Full Name | Cgr Beacon Clinic, Pa |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3782 Tamiami Trl, Port Charlotte, Florida |
| Authorized Official Name and Position | Charlene Joan Rosenfield (ARNP) |
| Authorized Official Contact | 9416297855 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cgr Beacon Clinic, Pa Po Box 496080 Port Charlotte FL 33949-6080 Ph: (941) 629-7855 | Cgr Beacon Clinic, Pa 3782 Tamiami Trl Port Charlotte FL 33952-8353 Ph: (941) 629-7855 |
| NPI Number | 1841220811 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841220811 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | ARNP2935382 (Florida) | Primary |
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