Healthcare Provider Details

I. General information

NPI: 1225611460
Provider Name (Legal Business Name): FLORIDA CENTER FOR CLINICAL RESEARCH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 05/05/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6056 BOYNTON BEACH BLVD STE 175
BOYNTON BEACH FL
33437-3500
US

IV. Provider business mailing address

8132 OKEECHOBEE BLVD STE B
WEST PALM BEACH FL
33411-2000
US

V. Phone/Fax

Practice location:
  • Phone: 561-708-1760
  • Fax:
Mailing address:
  • Phone: 561-290-1181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NATHALIE BASTIEN-MONTPEIROUS
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 561-708-1760