Active Health Clinic LLC
General Practice in Vero Beach, FL. Organization (NPI-2).
NPI number1417767518
StatusActive
Last updated in NPPESJan 27, 2025
Details
- NPI
- 1417767518
- Entity type
- Organization (NPI-2)
- Legal business name
- Active Health Clinic LLC
- Organization subpart
- No
- Enumeration date
- Jan 10, 2025
- Certification date
- Jan 27, 2025
- Last updated
- Jan 27, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
| 171400000X | Health & Wellness Coach | – | – | |
| 174H00000X | Health Educator | – | – | |
| 207QS0010X | Family Medicine, Sports Medicine | – | – | |
| 2083P0901X | Preventive Medicine, Public Health & General Preventive Medicine | – | – | |
| 251E00000X | Home Health | – | – | |
| 251F00000X | Home Infusion | – | – | |
| 261Q00000X | Clinic/Center | – | – | |
| 261QH0100X | Clinic/Center, Health Services | – | – |
Other names
- Active Health Clinic (Doing Business As)
Practice location
1948 Ocean Ridge CirVero Beach, FL 32963-2730
Phone 415-279-0947
Mailing address
1948 Ocean Ridge CirVero Beach, FL 32963-2730
Phone 415-279-0947
Authorized official
Kassra Michael Khazalpour
President
4152790947
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