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General NPI Number Information
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NPI Number | 1205406055
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Entity Type | Organization
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Legal Business Name | HEALTHSIDE, INC.
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Dates
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Enumeration Date | 06/24/2021
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Last Update Date | 07/19/2021
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Provider Practice Location Address
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Address Line | 4730 NW 2ND AVE STE 201
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City | BOCA RATON
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State | FL
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Zip | 33431-4169
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Country | US
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Telephone | 561-222-0275
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Fax |
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Provider Business Mailing Address
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Address Line | 4730 NW 2ND AVE STE 201
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City | BOCA RATON
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State | FL
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Zip | 33431-4169
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Country | US
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Telephone | 561-222-0275
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Fax |
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Authorized Official
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Title or Position | GENERAL COUNSEL
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Name | MR. ARAM C BLOOM
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Credential |
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Telephone | 561-222-0275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #6
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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 |
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Taxonomy #7
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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