Healthcare Provider Details

I. General information

NPI: 1558233015
Provider Name (Legal Business Name): THE MEDICAL DETECTIVE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4005 FARADAY WAY
PALM BEACH GARDENS FL
33418-6058
US

IV. Provider business mailing address

4005 FARADAY WAY
PALM BEACH GARDENS FL
33418-6058
US

V. Phone/Fax

Practice location:
  • Phone: 610-389-1545
  • Fax:
Mailing address:
  • Phone: 610-389-1545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: MRS. ERICA LANDES
Title or Position: INTEGRATIVE HEALTH PRACTITIONER
Credential:
Phone: 610-389-1545