MEDICARE: THRIVE HEALTH IV CLINIC PC

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	261QM1300X	Multi-Specialty Clinic/Center
2	261QI0500X	Infusion Therapy Clinic/Center

General Provider Information

NPI Number	:	1730903816
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIVE HEALTH IV CLINIC PC

Provider Business Mailing Address
First Line	:	9675 BRIGHTON WAY STE 410
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-5192
Country	:	US
Telephone Number	:	310-363-8757
Fax Number	:	310-363-8758

Provider Business Practice Location Address
First Line	:	410 W 41ST ST STE 406
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3504
Country	:	US
Telephone Number	:	310-363-8757
Fax Number	:	310-363-8758

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	KAREN M MULLEN
Credential	:
Telephone Number	:	310-363-8757

Provider Enumeration Date	:	11/14/2024
Last Update Date	:	06/10/2026

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