Healthcare Provider Details

I. General information

NPI: 1700426020
Provider Name (Legal Business Name): RED BRIDGE FAMILY & PSYCHIATRIC CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2020
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1054 GATEWAY BLVD STE 109
BOYNTON BEACH FL
33426-8309
US

IV. Provider business mailing address

111 NE 3RD AVE
BOYNTON BEACH FL
33435-3862
US

V. Phone/Fax

Practice location:
  • Phone: 561-715-4058
  • Fax: 850-633-2424
Mailing address:
  • Phone: 561-715-4058
  • Fax: 850-633-2424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. HEDEN PRESENDIEU
Title or Position: OWNER/PHYSICIAN
Credential: MD & DNP
Phone: 561-715-4058