Addiction Doctor of the Palm Beaches

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

ME53378 Issued in FL

Legal business name

ADDICTION DOCTOR OF THE PALM BEACHES

Practice address

789 SW Federal Hwy Ste 212
Stuart, FL 34994-2962

Phone

(772) 215-5905

Fax

(772) 905-3336

NPI assigned

Oct 22, 2014

Last updated

Apr 14, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Carl C. Gittens Sr., M.D.

Title

President

Phone

(772) 215-5905

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Carl C. Gittens MD PA Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1013311844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 SW FEDERAL HWY STE 212",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942962",
            "telephone_number": "772-215-5905",
            "fax_number": "772-905-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 SW FEDERAL HWY STE 212",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942962",
            "telephone_number": "772-215-5905",
            "fax_number": "772-905-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDICTION DOCTOR OF THE PALM BEACHES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-22",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "GITTENS",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-215-5905",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "ME53378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "ME53378",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carl C. Gittens MD PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Community/Behavioral Health Agency in Stuart, FL
• Providers in Stuart, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.