Healthcare Provider Details

I. General information

NPI: 1760257265
Provider Name (Legal Business Name): PATRIOTS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2023
Last Update Date: 11/15/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2540 METROCENTRE BLVD STE 1
WEST PALM BEACH FL
33407-3137
US

IV. Provider business mailing address

2540 METROCENTRE BLVD STE 1
WEST PALM BEACH FL
33407-3137
US

V. Phone/Fax

Practice location:
  • Phone: 978-828-1555
  • Fax:
Mailing address:
  • Phone: 978-828-1555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL RAY
Title or Position: OWNER
Credential:
Phone: 561-867-0001