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General NPI Number Information
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NPI Number | 1669262614
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Entity Type | Organization
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Legal Business Name | GENERATIONAL HEALTH OF FLORIDA
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 515 E LAS OLAS BLVD # 1301-I85
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-2296
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Country | US
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Telephone | 404-618-3676
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Fax |
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Provider Business Mailing Address
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Address Line | 515 E LAS OLAS BLVD # 1301-I85
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-2296
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JOHN DIXON
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Credential |
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Telephone | 214-985-2624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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