Healthcare Provider Details
I. General information
NPI: 1376014803
Provider Name (Legal Business Name): PRECISION HEALTH BY SCIENCE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/10/2018
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4443 LYONS RD STE 211
COCONUT CREEK FL
33073-4388
US
IV. Provider business mailing address
7611 MARBLEHEAD LN
PARKLAND FL
33067-2336
US
V. Phone/Fax
- Phone: 549-405-0501
- Fax: 954-301-8501
- Phone: 301-802-7731
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083P0901X |
| Taxonomy | Public Health & General Preventive Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
CYNTHIA
J
RILLING
Title or Position: COO
Credential:
Phone: 301-802-7731