Provider Demographics
NPI:1194151381
Name:CHRYSALIS INSTITUTE INC
Entity type:Organization
Organization Name:CHRYSALIS INSTITUTE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-394-2532
Mailing Address - Street 1:3648 MYKONOS CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1295
Mailing Address - Country:US
Mailing Address - Phone:561-789-9922
Mailing Address - Fax:561-210-1371
Practice Address - Street 1:8000 N FEDERAL HWY STE 110
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1681
Practice Address - Country:US
Practice Address - Phone:561-394-2532
Practice Address - Fax:561-210-1371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty