Healthcare Provider Details

I. General information

NPI: 1104635853
Provider Name (Legal Business Name): CIRCADIAN MEDICAL GROUP, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 LAKEVIEW AVE STE 735
WEST PALM BEACH FL
33401-6145
US

IV. Provider business mailing address

222 LAKEVIEW AVE STE 735
WEST PALM BEACH FL
33401-6145
US

V. Phone/Fax

Practice location:
  • Phone: 231-432-5841
  • Fax: 561-941-9454
Mailing address:
  • Phone: 231-432-5841
  • Fax: 561-941-9454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: NANCY HERRERA
Title or Position: CLINICAL OPERATIONS MANAGER
Credential:
Phone: 920-915-6995