| Faith Temple Medical Center, Llc | |
|
2499 Glades Rd Ste 113 Boca Raton FL 33431-7201 | |
| (561) 305-5668 | |
| Not Available |
| Full Name | Faith Temple Medical Center, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2499 Glades Rd Ste 113, Boca Raton, Florida |
| Authorized Official Name and Position | Michel Salomon (PRESIDENT) |
| Authorized Official Contact | 5613055668 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Faith Temple Medical Center, Llc 2499 Glades Rd Ste 113 Boca Raton FL 33431-7201 Ph: (561) 305-5668 | Faith Temple Medical Center, Llc 2499 Glades Rd Ste 113 Boca Raton FL 33431-7201 Ph: (561) 305-5668 |
| NPI Number | 1619622073 |
|---|---|
| Provider Enumeration Date | 02/15/2022 |
| Last Update Date | 12/13/2022 |
| Medicare PECOS PAC ID | 9335518257 |
|---|---|
| Medicare Enrollment ID | O20221214003095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619622073 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jean L Renelien |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215958400 PECOS PAC ID: 1951208099 Enrollment ID: I20031216000870 |
| Provider Name | Joel C Pelissier |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730454323 PECOS PAC ID: 5092961946 Enrollment ID: I20120808000365 |
| Provider Name | Frantzy Aurele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659709632 PECOS PAC ID: 7719356898 Enrollment ID: I20221212002701 |
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