Healthcare Provider Details

I. General information

NPI: 1093638538
Provider Name (Legal Business Name): DIGNITARY HEALTH PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9980 CENTRAL PARK BLVD N STE 322
BOCA RATON FL
33428-1704
US

IV. Provider business mailing address

9980 CENTRAL PARK BLVD N STE 322
BOCA RATON FL
33428-1704
US

V. Phone/Fax

Practice location:
  • Phone: 561-565-5727
  • Fax:
Mailing address:
  • Phone: 561-565-5727
  • Fax: 561-565-5528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LISAI ZHANG
Title or Position: OWNER
Credential: DO
Phone: 814-460-8960