| Mmd Professional Services, Corp. | |
|
1680 Sw Bayshore Blvd Ste 100 Port St Lucie FL 34984-3518 | |
| (772) 610-3947 | |
| (772) 610-3952 |
| Full Name | Mmd Professional Services, Corp. |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1680 Sw Bayshore Blvd Ste 100, Port St Lucie, Florida |
| Authorized Official Name and Position | Miguel A Garcia (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7867157072 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mmd Professional Services, Corp. 1680 Sw Bayshore Blvd Ste 100 Port St Lucie FL 34984-3518 Ph: (772) 610-3947 | Mmd Professional Services, Corp. 1680 Sw Bayshore Blvd Ste 100 Port St Lucie FL 34984-3518 Ph: (772) 610-3947 |
| NPI Number | 1740926757 |
|---|---|
| Provider Enumeration Date | 05/11/2022 |
| Last Update Date | 05/11/2022 |
| Certification Date | 05/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740926757 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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