Delray Beach Wellness Center LLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

DELRAY BEACH WELLNESS CENTER LLC

Practice address

1300 NW 17TH Ave
Suite 145
Delray Beach, FL 33445-2578

Phone

(844) 763-9968

Fax

(877) 281-1665

NPI assigned

Apr 17, 2017

Organization subpart

No

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

Authorized official

Name

Veronica Hernandez

Title

Billing Manager

Phone

(954) 203-3584

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1992239917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 NW 17TH AVE",
            "address_2": "SUITE 145",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334452578",
            "telephone_number": "844-763-9968",
            "fax_number": "877-281-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 NW 17TH AVE",
            "address_2": "SUITE 145",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334452578",
            "telephone_number": "844-763-9968",
            "fax_number": "877-281-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELRAY BEACH WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-17",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "954-203-3584"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Delray Beach, FL
• Providers in Delray Beach, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; 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.