Healthcare Provider Details

I. General information

NPI: 1528744935
Provider Name (Legal Business Name): CLOUD HEALTH MEDICAL GROUP, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 S BROADWAY FL 4
WHITE PLAINS NY
10601-4413
US

IV. Provider business mailing address

801 US HIGHWAY 1
NORTH PALM BEACH FL
33408-3811
US

V. Phone/Fax

Practice location:
  • Phone: 602-562-7383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK SHEN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 707-347-9651