SUMMIT DETOX (NPI# 1104391648) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104391648 |
| Entity Type | Organization |
| Organization Name | SUMMIT DETOX |
| Practice Address |
3330 S. Federal Highway 3rd Floor Boynton Beach FL 33435 |
| Mailing Address |
Po Box 732138 Dallas TX 75373-2138 |
| Practice Telephone | 5615015260 |
| Practice Fax Number | 5615015263 |
| Mailing Telephone | 5615015260 |
| Mailing Fax Number | 5615015263 |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2018-10-11 |
| Authorized Official Name | MS. JORDAN LEIGH LAVTIERI (HEALTHCARE ADMINISTRATOR MANAGER) |
| Authorized Official Telephone | 5615015260 |
| Authorized Official Credential | BSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
3330 S. FEDERAL HIGHWAY 3RD FLOOR |
| City | BOYNTON BEACH |
| State | FL |
| Zip Code | 33435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649824186 | Sarah Gostich | Podiatrist | 2815 S Searest Blvd, Boynton Beach, FL 33435 | 2019-08-01 |
| 1104487768 | Amira Nabil Halim Ibrahim | Student in an Organized Health Care Education/Training Program | Florida Atlantic University Medicine-bethesda Hospital, 2623 S Seacrest Blvd, Boynton Beach, FL 33435 | 2019-06-25 |
| 1972064491 | Elizabeth Anita Calhoun | Emergency Medicine | Bethesda Hospital East, 2815 S. Seacrest Blvd., Boynton Beach, FL 33435 | 2019-03-27 |
| 1164983086 | Thomas Rex Peterson | Emergency Medicine | Fau Emergency Medicine, Bethesda Hospital East, Attn: Joanne Daly, 2815 S. Seacrest Blvd., Boynton Beach, FL 33435 | 2019-03-26 |
| 1033686068 | Valery L. Petit-homme | Behavior Technician | 515 Se 20th Ave, Apt 10a, Boynton Beach, FL 33435 | 2018-10-29 |
| 1184120008 | Zachariah Hatoum | Student in an Organized Health Care Education/Training Program | 2815 South Seacrest Blvd., Gme Suite Lower Level B, Boynton Beach, FL 33435 | 2018-03-30 |
| 1922503135 | Anneka Mariesha Hutton | Student in an Organized Health Care Education/Training Program | 2623 South Seacrest Boulevard, Florida Atlantic University Medicine At Bethesda Hospit, Boynton Beach, FL 33435 | 2018-03-28 |
| 1477079473 | Benezon LLC | Case Management | 609 Manatee Bay Drive, Boynton Beach, FL 33435 | 2017-08-21 |
| 1750814091 | Maria Mijares | Student in an Organized Health Care Education/Training Program | 2623 South Seacrest Blvd., Suite 100, Fau Medicine At Bhe, Boynton Beach, FL 33435 | 2017-04-04 |
| 1639617236 | Solid Rock Behavioral Health & Associates, Corp | Counselor | 418 Villa Cir, Boynton Beach, FL 33435 | 2017-02-03 |
| Find all providers in zip 33435 | ||||
| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528387065 | Janusz Henryk Swiatkowski | Psychiatry & Neurology | 415 S Federal Hwy, Boynton Beach, FL 33435-4931 | 2010-05-24 |
| 1396779054 | Allen Y Masry | Psychiatry & Neurology | 1325 S Congress Ave Ste 203, Boynton Beach, FL 33426-5874 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992313472 | Athena Medical LLC | Psychiatry & Neurology | 2001 Hollywood Blvd Ste 207, Hollywood, FL 33020-4536 | 2020-07-21 |
| 1720612013 | New Perspective Mental Health LLC | Psychiatry & Neurology | 6141 Sw 72nd St Ste 402, South Miami, FL 33143-5026 | 2020-02-26 |
| 1972165231 | Blossoming Wellbeing Corp. | Psychiatry & Neurology | 6622 32nd Way S, St Petersburg, FL 33712-5408 | 2019-07-07 |
| 1679057814 | United Health and Wellness Group, Inc. | Psychiatry & Neurology | 201 N Federal Hwy Ste 105, Deerfield Beach, FL 33441-3621 | 2018-09-24 |
| 1467934224 | Arh Medical Group LLC | Psychiatry & Neurology | 631 Us Highway 1 Ste 409, North Palm Beach, FL 33408-4621 | 2018-08-29 |
| 1255879060 | Round Care, Inc | Psychiatry & Neurology | 300 W Sunrise Blvd Ste 3, Ft Lauderdale, FL 33311-6200 | 2017-02-01 |
| 1154766541 | Paul Roberts | Psychiatry & Neurology | 8529 Southpark Cir, Suite 270, Orlando, FL 32819-9029 | 2013-04-30 |
| 1386910172 | Siddharth Singh Arora | Psychiatry & Neurology | 1811 S Orlando Ave Ste A, Cocoa Beach, FL 32931-2340 | 2012-03-27 |
| 1194010694 | Laurie Ann Solomon | Psychiatry & Neurology | 100 Newell Dr # L4100, Gainesville, FL 32611-1912 | 2011-06-13 |
| 1427364629 | Moraima Trujillo Md Pa | Psychiatry & Neurology | 1015 N Greenway Dr, Coral Gables, FL 33134-4759 | 2010-08-25 |
| Find all providers with the same taxonomy | ||||
| City | BOYNTON BEACH |
| Zip Code | 33435 |
Please comment or provide details below to improve the information on SUMMIT DETOX.
| 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.