Healthcare Provider Details

I. General information

NPI: 1083622237
Provider Name (Legal Business Name): FOUNDCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5205 GREENWOOD AVE STE 150
WEST PALM BEACH FL
33407-2406
US

IV. Provider business mailing address

2330 S CONGRESS AVE
WEST PALM BEACH FL
33406-7608
US

V. Phone/Fax

Practice location:
  • Phone: 561-848-8701
  • Fax: 561-848-9059
Mailing address:
  • Phone: 561-432-5849
  • Fax: 561-868-5652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER FRANCIS IRIZARRY
Title or Position: CEO
Credential:
Phone: 561-432-7901