Provider Demographics
NPI:1194541268
Name:YOUR HEALTH KLINIK LLC
Entity type:Organization
Organization Name:YOUR HEALTH KLINIK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:DORIVAL
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:561-282-8295
Mailing Address - Street 1:1540 SW 8TH ST # 1139
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-5827
Mailing Address - Country:US
Mailing Address - Phone:561-282-8295
Mailing Address - Fax:
Practice Address - Street 1:199 MULBERRY GROVE RD
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-4520
Practice Address - Country:US
Practice Address - Phone:561-282-8295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty