=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851285605
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARESQUARE PPEC OF PALM BEACH LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/05/2025
-----------------------------------------------------
Last Update Date | 06/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 222 PROFESSIONAL WAY
-----------------------------------------------------
City | WELLINGTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33414-6391
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-812-3611
-----------------------------------------------------
Fax | 561-812-3629
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 222 PROFESSIONAL WAY
-----------------------------------------------------
City | WELLINGTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33414-6391
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-812-3611
-----------------------------------------------------
Fax | 561-812-3629
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER
-----------------------------------------------------
Name | NIRAV PATEL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 561-812-3611
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM3000X
-----------------------------------------------------
Taxonomy Name | Medically Fragile Infants and Children Day Care
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------