CLUB2,LLC (NPI# 1629412515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629412515 |
| Entity Type | Organization |
| Organization Name | CLUB2,LLC |
| Practice Address |
1230 Crane Cove Blvd Gulf Breeze FL 32563-3191 |
| Mailing Address |
1175 Mary Kate Dr Gulf Breeze FL 32563-5542 |
| Practice Telephone | 8509346659 |
| Mailing Telephone | 8509346659 |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2013-04-22 |
| Authorized Official Name | DR. PAUL ROEBUCK HENNING (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8506969556 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0002X |
Clinic/Center Specialization: Emergency Care |
ME93462 | FL | Ambulatory Health Care Facilities |
| Street Address |
1230 CRANE COVE BLVD |
| City | GULF BREEZE |
| State | FL |
| Zip Code | 32563-3191 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588180475 | Sacred Heart Health System, Inc. | Orthopaedic Surgery | 4033 Gulf Breeze Pkwy, Ste D, Gulf Breeze, FL 32563 | 2017-08-22 |
| 1881121457 | Jay Arnold | Dentist | 1480 Tiger Park Ln, Gulf Breeze, FL 32563 | 2017-05-15 |
| 1457506826 | Horace Lindsay Simpson | Surgery | 4435 Gulf Breeze Pkwy, Gulf Breeze, FL 32563 | 2008-11-26 |
| 1972795508 | Barbara Mary Ebel | Anesthesiology | 4435 Gulf Breeze Parkway, Good Samaritan Clinic, Gulf Breeze, FL 32563 | 2007-08-17 |
| 1275670374 | Karen Cann | Physical Therapist | 4657 Gulf Breeze Pkwy., Suites A & B, Gulf Breeze, FL 32563 | 2007-01-30 |
| 1356423719 | Cynthia Urmos | Chiropractor | 2870 Gulf Breeze Parkway, Gulf Breeze, FL 32563 | 2006-10-19 |
| 1538260690 | Donna Theresa Englehart | Counselor | 3463 Sycamore Lane, Gulf Breeze, FL 32563 | 2006-09-25 |
| 1932695475 | Lynette Hale | Nurse Practitioner | 3416 Gulf Breeze Pkwy, Gulf Breeze, FL 32563 | 2018-07-09 |
| 1285136937 | Jessica Roth | Behavior Technician | 3208 Gulf Breeze Pkwy, Gulf Breeze, FL 32563 | 2018-03-07 |
| 1821511544 | Samantha Monroe | Behavior Technician | 3182 Gulf Breeze Pkwy, Gulf Breeze, FL 32563 | 2017-07-25 |
| Find all providers in zip 32563 | ||||
| Taxonomy Code | 261QE0002X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Emergency Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578651 | Bruce L Boros Md Pa | Clinic/Center | 13365 Overseas Hwy Ste 102, Marathon, FL 33050-3513 | 2020-01-27 |
| 1043861305 | Us American Trips LLC | Clinic/Center | 1920 Sw 68th Ave Fl 33324, Plantation, FL 33317-5023 | 2019-09-26 |
| 1508230467 | Baptist Health Medical Plaza Coral Gables | Clinic/Center | 10 Giralda Ave, Coral Gables, FL 33134-5303 | 2015-11-16 |
| 1972977809 | Baptist Health Medical Plaza Tamiami Trail | Clinic/Center | 14660 Sw 8th St, Miami, FL 33184-3135 | 2015-11-16 |
| 1558735415 | Baptist Health Urgent Care University | Clinic/Center | 1240 S Dixie Hwy, Coral Gables, FL 33146-2902 | 2015-11-16 |
| 1649644592 | Baptist Health Medical Plaza Brickell | Clinic/Center | 2660 Brickell Ave, Miami, FL 33129-2800 | 2015-11-16 |
| 1639543598 | Baptist Health Urgent Care Sawgrass | Clinic/Center | 12472 W Sunrise Blvd, Sunrise, FL 33323-2987 | 2015-11-16 |
| 1669846523 | Baptist Health Urgent Care Weston | Clinic/Center | 1642 Town Center Cir, Weston, FL 33326-3664 | 2015-11-16 |
| 1982006391 | Variety Children's Hospital | Clinic/Center | 8895 Sw 136th St, Miami, FL 33176-5816 | 2014-09-17 |
| 1023448529 | Movil Diagnostic Services, Inc | Clinic/Center | 11320 Nw 62nd Ave, Hialeah, FL 33012-2362 | 2013-11-19 |
| Find all providers with the same taxonomy | ||||
| City | GULF BREEZE |
| Zip Code | 32563 |
Please comment or provide details below to improve the information on CLUB2,LLC.
| 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.