Healthcare Provider Details

I. General information

NPI: 1023922747
Provider Name (Legal Business Name): BACKGROUNDS PT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5289 CANNON WAY
WEST PALM BEACH FL
33415-3700
US

IV. Provider business mailing address

5289 CANNON WAY
WEST PALM BEACH FL
33415-3700
US

V. Phone/Fax

Practice location:
  • Phone: 561-900-8792
  • Fax:
Mailing address:
  • Phone: 561-900-8792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: RACIEL ESCALONA
Title or Position: OWNER
Credential: DC
Phone: 561-900-8792