MEDICARE: PLAM BEACH STEM CELL 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	202D00000X	Integrative Medicine Physician

General Provider Information

NPI Number	:	1174307763
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLAM BEACH STEM CELL LLC

Provider Business Mailing Address
First Line	:	824 US HIGHWAY 1 STE 110
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-3838
Country	:	US
Telephone Number	:	561-651-9182
Fax Number	:	954-366-9228

Provider Business Practice Location Address
First Line	:	824 US HIGHWAY 1 STE 110
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-3838
Country	:	US
Telephone Number	:	561-651-9182
Fax Number	:	954-366-9228

Authorized Official
Title or Position	:	MANAGER
Name	:	BENJAMIN HANDY
Credential	:
Telephone Number	:	561-262-8161

Provider Enumeration Date	:	08/23/2023
Last Update Date	:	08/23/2023

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Directions to “PLAM BEACH STEM CELL LLC ” Practice Location

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