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General NPI Number Information
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NPI Number | 1023484565
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Entity Type | Organization
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Legal Business Name | THE HORMONE RESTORATION CENTER
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 12889 HWY 98 W SUITE 107B
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City | MIRAMAR BEACH
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State | FL
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Zip | 32550
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Country | US
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Telephone | 850-837-1271
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Fax | 850-460-2279
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Provider Business Mailing Address
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Address Line | 12889 US HIGHWAY 98 W SUITE 107B
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City | MIRAMAR BEACH
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State | FL
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Zip | 32550-3243
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Country | US
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Telephone | 850-837-1271
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Fax | 850-460-2279
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD CHERN
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Credential |
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Telephone | 850-837-1271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State | FL
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