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General NPI Number Information
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NPI Number | 1861016115
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Entity Type | Organization
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Legal Business Name | CENTERS FOR HEALTH PROMOTION, LLC
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Dates
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Enumeration Date | 06/02/2020
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Last Update Date | 02/23/2021
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Provider Practice Location Address
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Address Line | 1890 N UNIVERSITY DR STE 306
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-8963
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Country | US
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Telephone | 954-368-8784
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Fax |
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Provider Business Mailing Address
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Address Line | 1890 N UNIVERSITY DR STE 306
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-8963
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Country | US
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Telephone | 954-368-8784
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. DWIGHT C REYNOLDS
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Credential | MD
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Telephone | 954-368-8784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care 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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License Number |
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License Number State |
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