| Regenerative Medicine Of South Florida Ii, Llc | |
|
8280 S Jog Rd Boynton Beach FL 33472-2938 | |
| (561) 752-6546 | |
| (561) 737-7664 |
| Full Name | Regenerative Medicine Of South Florida Ii, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8280 S Jog Rd, Boynton Beach, Florida |
| Authorized Official Name and Position | Adam Zuckerman (OWNER) |
| Authorized Official Contact | 5617526546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Regenerative Medicine Of South Florida Ii, Llc 8280 S Jog Rd Boynton Beach FL 33472-2938 Ph: (561) 752-6546 | Regenerative Medicine Of South Florida Ii, Llc 8280 S Jog Rd Boynton Beach FL 33472-2938 Ph: (561) 752-6546 |
| NPI Number | 1568094928 |
|---|---|
| Provider Enumeration Date | 02/04/2020 |
| Last Update Date | 02/04/2020 |
| Medicare PECOS PAC ID | 8527496884 |
|---|---|
| Medicare Enrollment ID | O20200319001885 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568094928 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Lori F Soberal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215268628 PECOS PAC ID: 2264460377 Enrollment ID: I20050730000062 |
| Provider Name | Haley Outcalt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437648151 PECOS PAC ID: 9335497635 Enrollment ID: I20200318001949 |
| Provider Name | Lucia Veronica Silva Brullo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700411659 PECOS PAC ID: 7416386339 Enrollment ID: I20200327003010 |
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