Healthcare Provider Details

I. General information

NPI: 1225906324
Provider Name (Legal Business Name): DIGITAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9980 CENTRAL PARK BLVD N STE 116A
BOCA RATON FL
33428-1703
US

IV. Provider business mailing address

216 PARK RD N
ROYAL PALM BEACH FL
33411-4741
US

V. Phone/Fax

Practice location:
  • Phone: 561-563-3610
  • Fax: 561-834-2849
Mailing address:
  • Phone: 561-563-3610
  • Fax: 561-834-2849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: FERNANDO M LOPEZ-IVERN
Title or Position: OWNER
Credential: MD
Phone: 561-563-3610