| Fitmind Therapeutics Advanced Behavioral Health | |
|
12574 Flagler Center Blvd Ste 101 Jacksonville FL 32258-2615 | |
| (315) 269-0847 | |
| Not Available |
| Full Name | Fitmind Therapeutics Advanced Behavioral Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 12574 Flagler Center Blvd Ste 101, Jacksonville, Florida |
| Authorized Official Name and Position | Victoria Kozel (CEO) |
| Authorized Official Contact | 9046795439 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fitmind Therapeutics Advanced Behavioral Health 12574 Flagler Center Blvd Ste 101 Jacksonville FL 32258-2615 Ph: (315) 269-0847 | Fitmind Therapeutics Advanced Behavioral Health 12574 Flagler Center Blvd Ste 101 Jacksonville FL 32258-2615 Ph: (315) 269-0847 |
| NPI Number | 1811738768 |
|---|---|
| Provider Enumeration Date | 06/04/2024 |
| Last Update Date | 09/10/2024 |
| Medicare PECOS PAC ID | 9032644190 |
|---|---|
| Medicare Enrollment ID | O20241126002086 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811738768 | NPI | - | NPPES |
| Provider Name | Victoria V Kozel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518031202 PECOS PAC ID: 8022048958 Enrollment ID: I20110406000333 |
| Provider Name | Sarah F Boaz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588920250 PECOS PAC ID: 8921384223 Enrollment ID: I20170422000075 |
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