Seacrest Wellness Center

Primary specialty

Group Psychotherapy PsychologistTaxonomy code 103TP2701X

Legal business name

SEACREST WELLNESS CENTER

Practice address

7100 Camino Real Ste 404
Boca Raton, FL 33433-5510

Phone

(954) 415-3608

Fax

(866) 856-2122

NPI assigned

Sep 13, 2016

Organization subpart

No

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

Authorized official

Name

Jared Pruzan

Title

Cfo

Phone

(561) 990-2620

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1730637257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 CAMINO REAL STE 404",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334335510",
            "telephone_number": "954-415-3608",
            "fax_number": "866-856-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 CAMINO REAL STE 404",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334335510",
            "telephone_number": "954-415-3608",
            "fax_number": "866-856-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEACREST WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-13",
        "last_updated": "2019-02-06",
        "status": "A",
        "authorized_official_last_name": "PRUZAN",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "561-990-2620"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.