Beverly Wilusz | |
228 Brooks St Se Ste A Fort Walton Beach FL 32548-2821 | |
(850) 301-0446 | |
(850) 301-0442 |
Full Name | Beverly Wilusz |
---|---|
Speciality | Community/behavioral Health |
Location | 228 Brooks St Se Ste A, Fort Walton Beach, Florida |
Authorized Official Name and Position | Beverly Wilusz (OWNER) |
Authorized Official Contact | 8503010446 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Beverly Wilusz Po Box 846 Fort Walton Beach FL 32549-0846 Ph: (850) 301-0446 | Beverly Wilusz 228 Brooks St Se Ste A Fort Walton Beach FL 32548-2821 Ph: (850) 301-0446 |
NPI Number | 1275946535 |
---|---|
Provider Enumeration Date | 06/04/2014 |
Last Update Date | 06/04/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275946535 | NPI | - | NPPES |
MH-2007 | Other | FL | FLORIDA BLUE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | MH-2007 (Florida) | Primary |
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