Healthcare Provider Details

I. General information

NPI: 1144181603
Provider Name (Legal Business Name): GUIDED HEALTH FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2025
Last Update Date: 11/22/2025
Certification Date: 11/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 PALM BEACH LAKES BLVD # 3000
WEST PALM BEACH FL
33409-6510
US

IV. Provider business mailing address

211 REENA DR
DAYTONA BEACH FL
32117-0065
US

V. Phone/Fax

Practice location:
  • Phone: 561-317-8454
  • Fax:
Mailing address:
  • Phone: 561-317-8454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MOLINE J BLANC
Title or Position: PRESIDENT
Credential: MSBS, PA-C
Phone: 561-317-8454