MEDICARE: RED BRIDGE FAMILY & PSYCHIATRIC CARE, 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
2	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700426020
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RED BRIDGE FAMILY & PSYCHIATRIC CARE, LLC

Provider Business Mailing Address
First Line	:	111 NE 3RD AVE
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-3862
Country	:	US
Telephone Number	:	561-715-4058
Fax Number	:	850-633-2424

Provider Business Practice Location Address
First Line	:	1054 GATEWAY BLVD STE 109
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-8309
Country	:	US
Telephone Number	:	561-715-4058
Fax Number	:	850-633-2424

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. HEDEN PRESENDIEU
Credential	:	MD & DNP
Telephone Number	:	561-715-4058

Provider Enumeration Date	:	01/14/2020
Last Update Date	:	08/17/2023

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Directions to “RED BRIDGE FAMILY & PSYCHIATRIC CARE, LLC ” Practice Location

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