Idina Health, Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

IDINA HEALTH, INC.

Practice address

8481 Siciliano St
Boynton Beach, FL 33472-7168

Phone

(561) 702-8403

NPI assigned

Nov 7, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Henry Lavon Hall

Title

President

Phone

(561) 702-8403

Specialties & licenses 1

Addresses

Other names 1

• Idina Health Other name

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667779200000",
    "number": "1528776705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8927 HYPOLUXO RD # A-118",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334675262",
            "telephone_number": "562-702-8403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8481 SICILIANO ST",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334727168",
            "telephone_number": "561-702-8403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDINA HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "LAVON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-702-8403",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Idina Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.