Provider Demographics
NPI:1063752475
Name:PALM HOLISTIC HEALTHCARE CENTER
Entity type:Organization
Organization Name:PALM HOLISTIC HEALTHCARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-455-0750
Mailing Address - Street 1:1177 GEORGE BUSH BLVD
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-7288
Mailing Address - Country:US
Mailing Address - Phone:561-455-0750
Mailing Address - Fax:561-276-3588
Practice Address - Street 1:1590 NE 162ND ST
Practice Address - Street 2:SUITE 400
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4759
Practice Address - Country:US
Practice Address - Phone:305-919-7877
Practice Address - Fax:305-945-6445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171100000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty