Provider Demographics
NPI:1033965769
Name:PRECISION MEDICAL BHRT INC
Entity Type:Organization
Organization Name:PRECISION MEDICAL BHRT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PA-C
Authorized Official - Prefix:MR
Authorized Official - First Name:CARSON
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:561-794-5068
Mailing Address - Street 1:1691 FORUM PL STE B164
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BCH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2336
Mailing Address - Country:US
Mailing Address - Phone:561-794-5068
Mailing Address - Fax:
Practice Address - Street 1:1691 FORUM PL STE B164
Practice Address - Street 2:
Practice Address - City:WEST PALM BCH
Practice Address - State:FL
Practice Address - Zip Code:33401-2336
Practice Address - Country:US
Practice Address - Phone:561-794-5068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty