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HEALTHY COMMUNITY CENTER LLC NPI 1205535572


NPI Information

NPI: 1205535572
Provider Name: HEALTHY COMMUNITY CENTER LLC

Other Name: DBA. HEALTHY MEDICAL CENTER

Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
506 SE 47TH TER STE B
CAPE CORAL, FL
ZIP 33904
Phone: (305) 989-1837
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HEALTHY COMMUNITY CENTER LLC is a general practice in Cape Coral, FL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee HEALTHY COMMUNITY CENTER LLC NPI is 1205535572. The provider is registered as an organization entity type.
The provider Other Name Is Dba. Healthy Medical Center.

The provider's business location address is:

506 SE 47TH TER STE B
CAPE CORAL, FL
ZIP 33904-593
Phone: (305) 989-1837

The provider's authorized official is Jeff Garcia .
The authorized official title is President and has the following contact phone number (239) 673-9825.

The enumeration date for this NPI number is 2/27/2023 and was last updated on 1/16/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral HealthNo
2261Q00000XClinic/CenterNo
3208D00000XGeneral PracticeYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1NX985OTHERFLORIDAINTERNAL MEDICINE
2117334100MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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