| Smart For Life | |
|
3196 N Federal Hwy Boca Raton FL 33431-6700 | |
| (561) 418-2505 | |
| (855) 948-4128 |
| Full Name | Smart For Life |
|---|---|
| Speciality | Family Medicine |
| Location | 3196 N Federal Hwy, Boca Raton, Florida |
| Authorized Official Name and Position | George Thomas (PRESIDENT & CEO) |
| Authorized Official Contact | 5614182505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smart For Life 3196 N Federal Hwy Boca Raton FL 33431-6700 Ph: (561) 418-2505 | Smart For Life 3196 N Federal Hwy Boca Raton FL 33431-6700 Ph: (561) 418-2505 |
| NPI Number | 1740551498 |
|---|---|
| Provider Enumeration Date | 01/25/2012 |
| Last Update Date | 06/01/2022 |
| Medicare PECOS PAC ID | 6800059577 |
|---|---|
| Medicare Enrollment ID | O20120516000065 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740551498 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | ME83741 (Florida) | Secondary |
| Provider Name | Isidro G Pentzke |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1174716799 PECOS PAC ID: 6103919311 Enrollment ID: I20070904000671 |
| Provider Name | Brad C Lipson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508930447 PECOS PAC ID: 4284700261 Enrollment ID: I20080828000281 |
| Provider Name | Sasson Elihue Moulavi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619248358 PECOS PAC ID: 3375706146 Enrollment ID: I20120516000034 |
| Provider Name | Brittany D Mcdowell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477952133 PECOS PAC ID: 1153543368 Enrollment ID: I20141103001990 |
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