| Phyllis Mccolister-cunningham Pa | |
|
900 Virginia Ave Ste 7 Fort Pierce FL 34982-5882 | |
| (772) 448-4189 | |
| (772) 245-4259 |
| Full Name | Phyllis Mccolister-cunningham Pa |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 900 Virginia Ave Ste 7, Fort Pierce, Florida |
| Authorized Official Name and Position | Phyllis Mccolister-cunningham (CEO & OWNER) |
| Authorized Official Contact | 7724484189 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phyllis Mccolister-cunningham Pa 900 Virginia Ave Ste 7 Fort Pierce FL 34982-5882 Ph: (772) 448-4189 | Phyllis Mccolister-cunningham Pa 900 Virginia Ave Ste 7 Fort Pierce FL 34982-5882 Ph: (772) 448-4189 |
| NPI Number | 1245766807 |
|---|---|
| Provider Enumeration Date | 05/02/2017 |
| Last Update Date | 12/05/2023 |
| Certification Date | 12/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245766807 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MH14456 (Florida) | Primary |
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