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4975 Park Ridge Blvd Bldg 5 Boynton Beach FL 33426-8318 | |
| (561) 806-6835 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 4975 Park Ridge Blvd Bldg 5, Boynton Beach, Florida |
| Authorized Official Name and Position | Deanna Warren (CEO) |
| Authorized Official Contact | 5618066835 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
639 E Ocean Ave Ste 409 Boynton Beach FL 33435-5017 Ph: (561) 806-6835 | 4975 Park Ridge Blvd Bldg 5 Boynton Beach FL 33426-8318 Ph: (561) 806-6835 |
| NPI Number | 1285415661 |
|---|---|
| Provider Enumeration Date | 10/11/2023 |
| Last Update Date | 11/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285415661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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