Provider Demographics
NPI:1467064824
Name:VALLEY OF HOPE HOLISTIC MEDICAL CENTER
Entity type:Organization
Organization Name:VALLEY OF HOPE HOLISTIC MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IMMACULA
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-321-7761
Mailing Address - Street 1:2100 45TH ST STE B23B24
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2016
Mailing Address - Country:US
Mailing Address - Phone:561-814-2786
Mailing Address - Fax:
Practice Address - Street 1:2100 45TH ST STE B23B24
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2016
Practice Address - Country:US
Practice Address - Phone:561-814-2786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FATIMA MEDICAL GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty