Southeastern Integrated Medical Pl

NPI #1093970162 in Gainesville, Florida

Provider Information

NPI Number: 1093970162
Entity Type: Organization
Organization Name: Southeastern Integrated Medical Pl
Subpart: Yes (part of a larger organization)
Parent Organization: SOUTHEASTERN INTEGRATED MEDICAL PL
Primary Specialty: Counselor - Mental Health
Enumeration Date: Jul 28, 2008
Last Updated: Jul 28, 2008

Practice Location

Address: 4881 NW 8TH AVE
Address 2: SUITE 2
City: Gainesville
State: Florida
ZIP Code: 32605-4582
Phone: (352) 224-2486

Authorized Official

Name: MR. JESSE C BRANNEN
Title: CHIEF OPERATING OFFICER
Phone: (352) 224-2200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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