ACTIVE HEALTH CLINIC LLC NPI 1417767518

NPI Information

NPI: 1417767518
Provider Name: ACTIVE HEALTH CLINIC LLC
Classification: General Practice - 208D00000X
Entity Type: Organization
:
Address: 1948 OCEAN RIDGE CIR
VERO BEACH, FL
ZIP 32963
Phone: (415) 279-0947

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NPI Details

ACTIVE HEALTH CLINIC LLC is a general practice in Vero Beach, 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 ACTIVE HEALTH CLINIC LLC NPI is 1417767518. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

1948 OCEAN RIDGE CIR
VERO BEACH, FL
ZIP 32963-730
Phone: (415) 279-0947

The provider's authorized official is KASSRA MICHAELMichael Khazalpour .
The authorized official title is President and has the following contact phone number (415) 279-0947.

The enumeration date for this NPI number is 1/10/2025 and was last updated on 1/27/2025.

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 Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	171400000X	Health and Wellness Coach		No
2	174H00000X	Health Educator		No
3	207QS0010X	Family Medicine	Sports Medicine	No
4	2083P0901X	Preventive Medicine	Public Health & General Preventive Medicine	No
5	208D00000X	General Practice		Yes
6	251E00000X	Home Health		No
7	251F00000X	Home Infusion		No
8	261Q00000X	Clinic/Center		No
9	261QH0100X	Clinic/Center	Health Service	No

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: 11/21/2025

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