The Clinic, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME101767 Issued in FL

Legal business name

THE CLINIC, LLC

Practice address

3370 Burns Rd
Suite 103
Palm Beach Gardens, FL 33410-4327

Phone

(561) 627-0772

Fax

(888) 235-9876

NPI assigned

Mar 11, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Javedul Haque II, M.D.NPI 1740253343

Title

Owner

Phone

(561) 627-0772

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Networks

• HealthSun Health Plans Network

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Javedul Haque II, MD

  • Psychiatry Physician
  • Dover, OH
  • NPI 1740253343

  FL

  Medicare reassignment NPD Authorized official
• Danish Fakhar Malik, MD

  • Internal Medicine Physician
  • Jupiter, FL
  • NPI 1639608300
  Medicare reassignment NPD
• Farzana Malik, M.D.

  • Internal Medicine Physician
  • North Canton, OH
  • NPI 1235342726

  FL

  Medicare reassignment NPD
• Ejaz Nemat, MD

  • Internal Medicine Physician
  • Jupiter, FL
  • NPI 1588602460
  NPD

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268265600000",
    "number": "1235452764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 SEPTEMBER ST",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334101521",
            "telephone_number": "561-627-0772",
            "fax_number": "888-235-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3370 BURNS RD",
            "address_2": "SUITE 103",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104327",
            "telephone_number": "561-627-0772",
            "fax_number": "888-235-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-11",
        "last_updated": "2010-03-11",
        "status": "A",
        "authorized_official_last_name": "HAQUE",
        "authorized_official_first_name": "JAVEDUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-627-0772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME101767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "1453G",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.