HANGOVER IV & BEAUTY THERAPY (NPI# 1043788425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043788425 |
| Entity Type | Organization |
| Organization Name | HANGOVER IV & BEAUTY THERAPY |
| Practice Address |
4600 Military Trl Ste 110 Jupiter FL 33458-4811 |
| Mailing Address |
17977 Keylime Blvd Loxahatchee FL 33470 |
| Practice Telephone | 5617743443 |
| Practice Fax Number | 5616306011 |
| Mailing Telephone | 5617743443 |
| Mailing Fax Number | 5616306011 |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2018-11-05 |
| Authorized Official Name | ANABEL GODINEZ (VICE PRESIDENT) |
| Authorized Official Telephone | 5617743443 |
| Is Organization Subpart | Y |
| Parent Organization Name | PURE IV THERAPY HEALTH & WELLNESS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RI0001X |
Internal Medicine Specialization: Clinical & Laboratory Immunology |
Allopathic & Osteopathic Physicians | ||
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| N | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| PURE IV THERAPY HEALTH & WELLNESS | Doing Business As Name - Organization |
| Street Address |
4600 MILITARY TRL STE 110 |
| City | JUPITER |
| State | FL |
| Zip Code | 33458-4811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801389028 | Jupiter Health and Wellness, LLC | Internal Medicine | 4600 Military Trl Ste 110, Jupiter, FL 33458-4811 | 2018-06-12 |
| 1396212684 | Pure Iv Health & Wellness LLC | Clinic/Center | 4600 Military Trl Ste 110, Jupiter, FL 33458-4811 | 2018-10-25 |
| 1336615632 | Jupiter Wellness Center, LLC | Internal Medicine | 4600 Military Trl Ste 110, Jupiter, FL 33458-4811 | 2018-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538780978 | Palm Beach Concierge Pt, LLC | Physical Therapist | 1166 Egret Cir S, Jupiter, FL 33458 | 2020-04-27 |
| 1346714789 | Shirley Dumas Gilbert | Counselor | 1132 W Indiantown Rd Unit 202, Jupiter, FL 33458 | 2019-01-18 |
| 1326518986 | Donald George Williams Jr. | Pharmacist | 5500 Military Trail, Jupiter, FL 33458 | 2018-11-27 |
| 1306329693 | William A Tison IIi | Physician Assistant | 2055 Military Trail Suite 204, Jupiter, FL 33458 | 2018-09-12 |
| 1588146930 | Joanna Peros | Psychologist | 210 Jupiter Lakes Blvd. Unit 3102, Jupiter, FL 33458 | 2018-09-02 |
| 1528558301 | Brian Pratt | Registered Nurse | 871 University Blvd Apt 207, Jupiter, FL 33458 | 2018-05-16 |
| 1306352133 | Katherine Janis Rivera | Nurse Anesthetist, Certified Registered | Jupiter Medical Center 1210 Old Dixie Hwy, Jupiter, FL 33458 | 2017-12-15 |
| 1992235436 | Barborka Schmidt | Pharmacist | 6650 W Indiantown Road, Suite 100, Aarav Pharmacy LLC, Jupiter, FL 33458 | 2017-06-18 |
| 1114453834 | Elite-e Counseling | Social Worker | 2055 Military Trail Suite 306 Jupiter, Jupiter, FL 33458 | 2017-05-02 |
| 1669910667 | Kristy Lee Caronia | Nurse Anesthetist, Certified Registered | 175 Edenberry Ave, Jupiter, FL 33458 | 2017-02-09 |
| Find all providers in zip 33458 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1083073399 | Healthy Living Physicians Services, LLC | Clinic/Center | 250 Thelma Ave, Jupiter, FL 33458-8091 | 2016-02-15 |
| 1225179450 | The Medical Group of South Florida Inc | Clinic/Center | 1094 Military Trl, Jupiter, FL 33458-7021 | 2007-02-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.