TREASURE COAST KETAMINE WELLNESS & IV NUTRITION CENTER (NPI# 1801408208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801408208 |
| Entity Type | Organization |
| Organization Name | TREASURE COAST KETAMINE WELLNESS & IV NUTRITION CENTER |
| Practice Address |
777 37th St Ste B106 Vero Beach FL 32960-7301 |
| Practice Telephone | 7729075917 |
| Practice Fax Number | 7729075917 |
| Mailing Telephone | 7729075917 |
| Mailing Fax Number | 7729075917 |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2020-08-18 |
| Authorized Official Name | GREGORY JARRELL MCCRACKEN (OWNER) |
| Authorized Official Telephone | 3522628439 |
| Authorized Official Credential | CRNA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WI0500X |
Registered Nurse Specialization: Infusion Therapy |
Nursing Service Providers |
| Street Address |
777 37TH ST STE B106 |
| City | VERO BEACH |
| State | FL |
| Zip Code | 32960-7301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073712592 | Ellen Jb Maxson | Technician, Other | 777 37th St Ste B106, Vero Beach, FL 32960-7301 | 2007-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891208872 | Fresenius Medical Care Vero Beach, LLC | Clinic/Center | 1515 Indian River Blvd Ste A101, Vero Beach, FL 32960 | 2017-11-13 |
| 1972016103 | Rer Enterprises, Inc. | Durable Medical Equipment & Medical Supplies | 2436 Us 1, Vero Beach, FL 32960 | 2017-11-09 |
| 1225558141 | Robby John Caballes | Podiatrist | 3735 11th Circle Ste 201, Vero Beach, FL 32960 | 2017-06-21 |
| 1407388978 | Haley Elizabeth Stewart | Counselor | 1925 20th Street, Vero Beach, FL 32960 | 2017-04-03 |
| 1861932949 | Daniel Martin | Specialist/Technologist | 4025 20th Street, Vero Beach, FL 32960 | 2017-03-08 |
| 1770957367 | Gail Jaffe Satuloff | Counselor | Terry Mindfulness Center, 333 17th St., Suite 2t, Vero Beach, FL 32960 | 2015-11-19 |
| 1104213172 | Kimberly Ann Aikey | Massage Therapist | 1715 37th Place #3, Vero Beach, FL 32960 | 2015-04-17 |
| 1992128482 | Jean Luc Franck | Internal Medicine | 920 37th Pl Ste 105, Vero Beach, FL 32960 | 2014-02-04 |
| 1417386624 | Ocean Addiction Recovery Services, LLC | Anesthesiology | 1705 19 Pl, Ste E-2, Vero Beach, FL 32960 | 2013-11-07 |
| 1609203835 | Cynthia S. Crawford, M.d. Pa | Physical Medicine & Rehabilitation | 1986 35th Avenue, Vero Beach, FL 32960 | 2013-10-02 |
| Find all providers in zip 32960 | ||||
| Taxonomy Code | 163WI0500X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Infusion Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568069441 | Integrated Comprehensive Urgent Care, LLC. | Registered Nurse | 9090 Sw 87th Ct Ste 100, Miami, FL 33176-2317 | 2020-10-05 |
| 1104466705 | Mario Bation Siasoyco | Registered Nurse | 2115 Morgan Wieland Ln Apt 202, Lakeland, FL 33813-3181 | 2020-01-10 |
| 1316369044 | Signature Staff Solutions, LLC | Registered Nurse | 3830 Crown Point Rd Ste F, Jacksonville, FL 32257-7553 | 2014-01-15 |
| 1770787145 | Btn Infusion Inc | Registered Nurse | 6442 49th Ave N, St Petersburg, FL 33709 | 2007-06-12 |
| 1598313728 | Angela Isabel Soto | Registered Nurse | 13800 Veterans Way, Orlando, FL 32827-7401 | 2019-08-30 |
| 1053977538 | Renay Natlie Smith | Registered Nurse | 8932 Sw 97th Ave, Miami, FL 33176-1936 | 2019-05-10 |
| 1740846195 | Nadege Sanon | Registered Nurse | 2780 Cleveland Ave, Fort Myers, FL 33901-5858 | 2019-05-10 |
| 1477034601 | Tiffany Christine Kimble | Registered Nurse | 2401 60th Street Ct W, Bradenton, FL 34209-5500 | 2018-08-26 |
| 1609363407 | Gina Kinsey | Registered Nurse | 840 Us Highway 1 Ste 120, North Palm Beach, FL 33408-3858 | 2018-04-17 |
| 1386048809 | Picc Line Professionals | Registered Nurse | 6740 Nw 45th Ct, Lauderhill, FL 33319-4037 | 2014-10-13 |
| Find all providers with the same taxonomy | ||||
| City | VERO BEACH |
| Zip Code | 32960 |
Please comment or provide details below to improve the information on TREASURE COAST KETAMINE WELLNESS & IV NUTRITION CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.