Provider Demographics
NPI:1801360870
Name:CLINICAL ACUMEN LLC.
Entity Type:Organization
Organization Name:CLINICAL ACUMEN LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:RISTUCCIA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:904-521-0934
Mailing Address - Street 1:PO BOX 291783
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-1783
Mailing Address - Country:US
Mailing Address - Phone:904-521-0934
Mailing Address - Fax:
Practice Address - Street 1:3780 S NOVA RD STE 6
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32129-4203
Practice Address - Country:US
Practice Address - Phone:904-521-0934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center