MEDICARE: CORE HEALTHCARE ALLIANCE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1083357313
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORE HEALTHCARE ALLIANCE, LLC

Provider Business Mailing Address
First Line	:	2326 S CONGRESS AVE STE 1C
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-7652
Country	:	US
Telephone Number	:
Fax Number	:	561-828-3974

Provider Business Practice Location Address
First Line	:	2326 S CONGRESS AVE STE 1C
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-7652
Country	:	US
Telephone Number	:	775-319-5201
Fax Number	:	561-828-3974

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE
Name	:	MISS CHRISTINE CLARK
Credential	:
Telephone Number	:	561-373-5835

Provider Enumeration Date	:	04/14/2022
Last Update Date	:	05/26/2026

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