Provider Demographics
NPI:1346818283
Name:CONCERT HEALTH FLORDIA, LLC
Entity Type:Organization
Organization Name:CONCERT HEALTH FLORDIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/ AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-797-4020
Mailing Address - Street 1:550 W B ST FL 4
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-3537
Mailing Address - Country:US
Mailing Address - Phone:917-618-4161
Mailing Address - Fax:
Practice Address - Street 1:618 E SOUTH ST STE 500
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-2986
Practice Address - Country:US
Practice Address - Phone:000-000-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty