| Athena Medical Llc | |
|
45 W 17th St Riviera Beach FL 33404-6121 | |
| (954) 314-8202 | |
| (954) 842-4347 |
| Full Name | Athena Medical Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 45 W 17th St, Riviera Beach, Florida |
| Authorized Official Name and Position | Bryan Alzate (CEO) |
| Authorized Official Contact | 9543148202 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Athena Medical Llc 9050 Pines Blvd Ste 460 Pembroke Pines FL 33024-6402 Ph: (954) 314-8202 | Athena Medical Llc 45 W 17th St Riviera Beach FL 33404-6121 Ph: (954) 314-8202 |
| NPI Number | 1992313472 |
|---|---|
| Provider Enumeration Date | 07/21/2020 |
| Last Update Date | 12/17/2020 |
| Certification Date | 12/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992313472 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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