| Spirit Of Key West Llc | |
|
5629 Holiday Rd Buford GA 30518-1519 | |
| (678) 765-8622 | |
| (678) 765-8621 |
| Full Name | Spirit Of Key West Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 5629 Holiday Rd, Buford, Georgia |
| Authorized Official Name and Position | Jana Renee Himmelbaum (OWNER) |
| Authorized Official Contact | 6787658622 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spirit Of Key West Llc 5629 Holiday Rd Buford GA 30518-1519 Ph: (678) 765-8622 | Spirit Of Key West Llc 5629 Holiday Rd Buford GA 30518-1519 Ph: (678) 765-8622 |
| NPI Number | 1881138279 |
|---|---|
| Provider Enumeration Date | 12/05/2016 |
| Last Update Date | 03/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881138279 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 75152 (Georgia) | Primary |
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