Provider Demographics
NPI:1225611460
Name:FLORIDA CENTER FOR CLINICAL RESEARCH INC.
Entity Type:Organization
Organization Name:FLORIDA CENTER FOR CLINICAL RESEARCH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BASTIEN-MONTPEIROUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-708-1760
Mailing Address - Street 1:8132 OKEECHOBEE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2000
Mailing Address - Country:US
Mailing Address - Phone:561-290-1181
Mailing Address - Fax:
Practice Address - Street 1:6056 BOYNTON BEACH BLVD STE 175
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3500
Practice Address - Country:US
Practice Address - Phone:561-708-1760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health