Healthcare Provider Details

I. General information

NPI: 1336516798
Provider Name (Legal Business Name): ADDICTION RECOVERY MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2015
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 SE 23RD AVE
BOYNTON BEACH FL
33435-7620
US

IV. Provider business mailing address

222 YAMATO RD SUITE 106-225
BOCA RATON FL
33431-4704
US

V. Phone/Fax

Practice location:
  • Phone: 561-303-2912
  • Fax: 561-303-2951
Mailing address:
  • Phone: 561-303-2912
  • Fax: 561-303-2951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License NumberOS12975
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number5001
License Number StateFL

VIII. Authorized Official

Name: DR. MAX LOUIS CITRIN
Title or Position: PHYSICIAN
Credential: D.O.
Phone: 56130322912