Providence Community Health LLC
Nurse Practitioner in Palm Springs, FL. Organization (NPI-2).
NPI number1093471815
StatusActive
Last updated in NPPESJul 31, 2025
Details
- NPI
- 1093471815
- Entity type
- Organization (NPI-2)
- Legal business name
- Providence Community Health LLC
- Organization subpart
- No
- Enumeration date
- Nov 16, 2021
- Certification date
- Jul 31, 2025
- Last updated
- Jul 31, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | – | – | Yes |
Practice location
2150 S Congress AvePalm Springs, FL 33406-7604
Phone 561-515-7759 · Fax 561-833-1101
Mailing address
2150 S Congress AvePalm Springs, FL 33406-7604
Phone 561-515-7759 · Fax 561-833-1101
Authorized official
Saul Ernest
Owner
5615157759
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