Healthcare Provider Details

I. General information

NPI: 1700740768
Provider Name (Legal Business Name): CARBON ADVANCED HUMAN CONDITIONING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 NW BOCA RATON BLVD STE A24
BOCA RATON FL
33431-6609
US

IV. Provider business mailing address

3 ROYAL PALM WAY
BOCA RATON FL
33432-7849
US

V. Phone/Fax

Practice location:
  • Phone: 561-614-9342
  • Fax:
Mailing address:
  • Phone: 561-614-9342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMES DAVIS
Title or Position: MGR
Credential: NA
Phone: 561-614-9342