Healthcare Provider Details

I. General information

NPI: 1487110995
Provider Name (Legal Business Name): EVERGLADES COLLEGE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2019
Last Update Date: 07/01/2023
Certification Date: 07/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2085 VISTA PARKWAY
WEST PALM BEACH FL
33411
US

IV. Provider business mailing address

2085 VISTA PARKWAY
WEST PALM BEACH FL
33411
US

V. Phone/Fax

Practice location:
  • Phone: 561-471-6000
  • Fax: 561-471-7849
Mailing address:
  • Phone: 561-471-6000
  • Fax: 561-471-7849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH CHRISTOPHER BERARDINELLI
Title or Position: TREASURER
Credential:
Phone: 954-776-4476