| Ketamine Health Centers Of West Palm Beach, Llc | |
|
1411 N Flagler Dr Ste 9000 West Palm Beach FL 33401-3421 | |
| (561) 766-0818 | |
| Not Available |
| Full Name | Ketamine Health Centers Of West Palm Beach, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1411 N Flagler Dr Ste 9000, West Palm Beach, Florida |
| Authorized Official Name and Position | Raul A Cruz (OWNER) |
| Authorized Official Contact | 3057934855 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ketamine Health Centers Of West Palm Beach, Llc 5745 Sw 51st St Miami FL 33155-6317 Ph: (305) 793-4855 | Ketamine Health Centers Of West Palm Beach, Llc 1411 N Flagler Dr Ste 9000 West Palm Beach FL 33401-3421 Ph: (561) 766-0818 |
| NPI Number | 1073179396 |
|---|---|
| Provider Enumeration Date | 05/13/2019 |
| Last Update Date | 07/31/2023 |
| Medicare PECOS PAC ID | 0042633414 |
|---|---|
| Medicare Enrollment ID | O20200702001412 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073179396 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Rosemary Daly |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1558341354 PECOS PAC ID: 9436130358 Enrollment ID: I20040526001563 |
| Provider Name | Raul A Cruz |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1144421454 PECOS PAC ID: 8123143583 Enrollment ID: I20100909000304 |
| Provider Name | Juan D Oms |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508067679 PECOS PAC ID: 2769674795 Enrollment ID: I20101206001231 |
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