MEDICARE: MINI HEALTH CLINIC OF THE PALM BEACHES, 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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1851228506
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINI HEALTH CLINIC OF THE PALM BEACHES, LLC

Provider Business Mailing Address
First Line	:	6818 ALISO AVE
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33413-1036
Country	:	US
Telephone Number	:	315-547-0502
Fax Number	:

Provider Business Practice Location Address
First Line	:	6818 ALISO AVE
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33413-1036
Country	:	US
Telephone Number	:	315-547-0502
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ADELINE NEZIFORT
Credential	:
Telephone Number	:	315-547-0502

Provider Enumeration Date	:	05/06/2026
Last Update Date	:	05/06/2026

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