Basic Information
| Provider Information | |||||||||
| NPI: | 1174241335 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | METRO TREATMENT OF FLORIDA, LP | ||||||||
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| Mailing Information | |||||||||
| Address1: | ATTN: COLONIAL MANAGEMENT GROUP LP LOCKBOX #440133 | ||||||||
| Address2: | P. O. BOX 440133 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37244 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073517080 | ||||||||
| FaxNumber: | 4073516930 | ||||||||
| Practice Location | |||||||||
| Address1: | 2209 NW 13TH ST | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326093426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3524745150 | ||||||||
| FaxNumber: | 3522932506 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2022 | ||||||||
| LastUpdateDate: | 08/15/2022 | ||||||||
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| AuthorizedOfficialLastName: | ROSADO | ||||||||
| AuthorizedOfficialFirstName: | HECTOR | ||||||||
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| AuthorizedOfficialTitleorPosition: | REGIONAL DIRECTOR PAYOR RELATIONS | ||||||||
| AuthorizedOfficialTelephone: | 4073517080 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM2800X | Y | Ambulatory Health Care Facilities | Clinic/Center | Methadone Clinic |
No ID Information.