PALM BEACH WELLNESS CENTER LLC NPI 1932415635

NPI Information

NPI: 1932415635
Provider Name: PALM BEACH WELLNESS CENTER LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 10D1105643

Address:
6169 S JOG RD
SUITE B3
LAKE WORTH, FL
ZIP 33467
Phone: (561) 433-9191
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PALM BEACH WELLNESS CENTER LLC is a primary care clinic center in Lake Worth, FL. PALM BEACH WELLNESS CENTER LLC NPI is 1932415635. The provider is registered as an organization entity type.

The provider's business location address is:

6169 S JOG RD
SUITE B3
LAKE WORTH, FL
ZIP 33467-579
Phone: (561) 433-9191
Fax: (561) 433-4404

The provider's authorized official is Chad Durnan .
The authorized official title is Managing Member and has the following contact phone number (561) 433-9191.

The CLIA number assigned to this NPI record is 10D1105643 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/19/2010 and was last updated on 3/15/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	8817	FLORIDA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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