Mint Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MINT CLINIC LLC

Practice address

1201 US Highway 1 Ste 305
North Palm Beach, FL 33408-3548

Phone

(917) 331-4321

NPI assigned

May 4, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Diego E Roca, NONE

Title

VP Controller

Phone

(561) 614-1090

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620086400000",
    "number": "1043893316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 US HIGHWAY 1 STE 305",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334083548",
            "telephone_number": "917-331-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 US HIGHWAY 1 STE 305",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334083548",
            "telephone_number": "917-331-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINT CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A",
        "authorized_official_last_name": "ROCA",
        "authorized_official_first_name": "DIEGO",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VP CONTROLLER",
        "authorized_official_telephone_number": "561-614-1090",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NONE"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bassem Gamal Ghaly Metry
• Michael Gallagher
• Milton Health Group
• Milton Recovery, LLC
• Antonia Marie Minervini, M.S., CF-SLP
• Misty Medical Supply Inc
• MNP Medical Group
• Scott A Moffitt, M.D.
• Reisha Montecinos
• Alexandra Marie Mooney, PA-C

• Clinic/Center in North Palm Beach, FL
• Providers in North Palm Beach, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.