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General NPI Number Information
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NPI Number | 1699466482
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Entity Type | Organization
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Legal Business Name | HEALING HANDS IV INFUSION CENTER LLC
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Dates
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Enumeration Date | 05/15/2023
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Last Update Date | 04/14/2024
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Provider Practice Location Address
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Address Line | 3141 S MILITARY TRL STE 108
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City | LAKE WORTH
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State | FL
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Zip | 33463-2133
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Country | US
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Telephone | 561-557-2223
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Fax | 561-473-5717
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Provider Business Mailing Address
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Address Line | 3141 S MILITARY TRL STE 108
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City | LAKE WORTH
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State | FL
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Zip | 33463-2133
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Country | US
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Telephone | 561-557-2223
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Fax | 561-473-5717
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JUPITER AMBROISE FLEURIMON
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Credential | RN-BSN
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Telephone | 561-473-5723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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Taxonomy #3
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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 #4
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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