Healthcare Provider Details

I. General information

NPI: 1851228506
Provider Name (Legal Business Name): MINI HEALTH CLINIC OF THE PALM BEACHES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6818 ALISO AVE
WEST PALM BEACH FL
33413-1036
US

IV. Provider business mailing address

6818 ALISO AVE
WEST PALM BEACH FL
33413-1036
US

V. Phone/Fax

Practice location:
  • Phone: 315-547-0502
  • Fax:
Mailing address:
  • Phone: 315-547-0502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ADELINE NEZIFORT
Title or Position: OWNER
Credential:
Phone: 315-547-0502