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General NPI Number Information
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NPI Number | 1972052215
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Entity Type | Organization
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Legal Business Name | THE HEALTH OASIS
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Dates
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Enumeration Date | 09/28/2016
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 350 CAMINO GARDENS BLVD 106
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City | BOCA RATON
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State | FL
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Zip | 33432-5846
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Country | US
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Telephone | 855-345-3334
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Fax |
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Provider Business Mailing Address
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Address Line | 350 CAMINO GARDENS BLVD 106
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City | BOCA RATON
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State | FL
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Zip | 33432-5846
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Country | US
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Telephone | 855-345-3334
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JACK FRYDMAN
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Credential |
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Telephone | 561-279-5221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | HCC10818
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | HCC10818
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License Number State | FL
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