Healthcare Provider Details

I. General information

NPI: 1073969879
Provider Name (Legal Business Name): FLORIDA ARTHRITIS & RHEUMATOLOGY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2016
Last Update Date: 02/05/2021
Certification Date: 02/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10151 ENTERPRISE CTR STE 100
BOYNTON BEACH FL
33437-3759
US

IV. Provider business mailing address

10151 ENTERPRISE CTR STE 100
BOYNTON BEACH FL
33437-3759
US

V. Phone/Fax

Practice location:
  • Phone: 844-697-4492
  • Fax:
Mailing address:
  • Phone: 844-697-4492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH29939
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN NELL GARRETT
Title or Position: EVP
Credential:
Phone: 561-699-7101