Healthcare Provider Details

I. General information

NPI: 1548541998
Provider Name (Legal Business Name): CENTER FOR NATURAL HEALING AND REGENERATIVE MEDICINE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2011
Last Update Date: 08/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 N STATE ROAD 7 203
MARGATE FL
33063-5737
US

IV. Provider business mailing address

2825 N STATE ROAD 7 203
MARGATE FL
33063-5737
US

V. Phone/Fax

Practice location:
  • Phone: 954-934-6256
  • Fax: 866-658-5450
Mailing address:
  • Phone: 954-934-6256
  • Fax: 866-658-5450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083S0010X
TaxonomySports Medicine (Preventive Medicine) Physician
License NumberME56773
License Number StateFL

VIII. Authorized Official

Name: DR. CHARLES MERSON
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 954-934-6256