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PINNACLE REHABILITATION GROUP NPI 1780247064


NPI Information

NPI: 1780247064
Provider Name: PINNACLE REHABILITATION GROUP
Classification: Family Medicine - 207QA0401X
Entity Type: Organization

Specialization: Addiction Medicine

CLIA Number: 10D2191617

Address:
1680 SE LYNGATE DR STE 204
PORT SAINT LUCIE, FL
ZIP 34952
Phone: (772) 222-5411
Get Directions

PINNACLE REHABILITATION GROUP is an addiction medicine family medicine in Port Saint Lucie, FL. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. PINNACLE REHABILITATION GROUP NPI is 1780247064. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1680 SE LYNGATE DR STE 204
PORT SAINT LUCIE, FL
ZIP 34952-300
Phone: (772) 222-5411
Fax: (772) 237-5496

The provider's authorized official is Kenneth Palestrant .
The authorized official title is Owner and has the following contact phone number (772) 222-5411.

The CLIA number assigned to this NPI record is 10D2191617 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/22/2019 and was last updated on 4/24/2019.


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 License Number License State Primary
1207QA0401XFamily MedicineAddiction MedicineYes

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: 5/5/2024

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