| Potentiel Illimite Corp | |
|
13220 Scharber Rd Dade City FL 33525-8008 | |
| (352) 588-5135 | |
| (352) 588-5135 |
| Full Name | Potentiel Illimite Corp |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 13220 Scharber Rd, Dade City, Florida |
| Authorized Official Name and Position | Daryl D Bozone (PRESIDENT) |
| Authorized Official Contact | 3525885135 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Potentiel Illimite Corp 13220 Scharber Rd Dade City FL 33525-8008 Ph: (352) 588-5135 | Potentiel Illimite Corp 13220 Scharber Rd Dade City FL 33525-8008 Ph: (352) 588-5135 |
| NPI Number | 1073922605 |
|---|---|
| Provider Enumeration Date | 08/07/2014 |
| Last Update Date | 08/07/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073922605 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW8851 (Florida) | Primary |
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