Individual provider · Type 1 NPI

Brian Tatum

Developmental Disabilities Clinic/Center · Port St. Lucie, FL

NPI number 1669984167 Active

Practice location

6905 Heritage Dr
Port St. Lucie, FL 34952-8227

Call (772) 370-5547 Map

Mailing address

4230 SW Callicoe St
Port St. Lucie, FL 34953-3189

Specialties and licenses

TaxonomyCodeLicense
Developmental Disabilities Clinic/Center Primary 261QD1600XNone listed

Developmental Disabilities Clinic/Center: An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).

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About NPI 1669984167

Brian Tatum's National Provider Identifier is 1669984167, issued on Oct 25, 2017. The primary taxonomy on file is Developmental Disabilities Clinic/Center (261QD1600X), and the practice location is in Port St. Lucie, FL. The record was last updated on Oct 25, 2017.