Centricity Mobile Health Center LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

CENTRICITY MOBILE HEALTH CENTER LLC

Practice address

6805 S Federal Hwy
Port St Lucie, FL 34952-1434

Phone

(772) 242-1269

NPI assigned

Apr 19, 2021

Organization subpart

No

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

Authorized official

Name

Binette Apsalon Dorminier

Title

Owner

Phone

(561) 319-2548

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618790400000",
    "number": "1578144705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6805 S FEDERAL HWY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349521434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6805 S FEDERAL HWY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349521434",
            "telephone_number": "772-242-1269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRICITY MOBILE HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A",
        "authorized_official_last_name": "DORMINIER",
        "authorized_official_first_name": "BINETTE",
        "authorized_official_middle_name": "APSALON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-319-2548"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.