MEDICARE: AISOL, 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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1568872356
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AISOL, LLC

Provider Business Mailing Address
First Line	:	2600 QUANTUM BLVD
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-8627
Country	:	US
Telephone Number	:	561-413-5755
Fax Number	:

Provider Business Practice Location Address
First Line	:	4875 PARK RIDGE BLVD STE 103
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-8345
Country	:	US
Telephone Number	:	561-413-5755
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	MICHAEL MADDALONI
Credential	:
Telephone Number	:	561-323-0049

Provider Enumeration Date	:	05/01/2014
Last Update Date	:	01/05/2026

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Directions to “AISOL, LLC ” Practice Location

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