NPIMap

Organization Active NPI

Holistic Medical Center of Fort Pierce LLC

  • Adult Medicine Physician
  • Fort Pierce, FL
National Provider Identifier
1912180308
Registry record updated Dec 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
HOLISTIC MEDICAL CENTER OF FORT PIERCE LLC
Practice address
2401 Frist Blvd
Suite 7
Fort Pierce, FL 34950-4839
Phone
(772) 621-7772
NPI assigned
Dec 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2007

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

Authorized official

Name
Ms. Barbara H Georgiades
Title
Owner
Phone
(772) 621-7772

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X FL Primary

Addresses

Primary practice location

2401 Frist Blvd
Suite 7
Fort Pierce, FL 34950-4839

Mailing address

2401 Frist Blvd
Suite 7
Fort Pierce, FL 34950-4839
Phone (772) 621-7772

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1197158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197158400000",
    "number": "1912180308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 FRIST BLVD",
            "address_2": "SUITE 7",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504839",
            "telephone_number": "772-621-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 FRIST BLVD",
            "address_2": "SUITE 7",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504839",
            "telephone_number": "772-621-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC MEDICAL CENTER OF FORT PIERCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-09",
        "last_updated": "2007-12-09",
        "status": "A",
        "authorized_official_last_name": "GEORGIADES",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-621-7772",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2007; 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.