Provider Demographics
NPI:1437343639
Name:PEARSON WELLNESS CENTER
Entity Type:Organization
Organization Name:PEARSON WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-290-7244
Mailing Address - Street 1:1201 US HIGHWAY 1
Mailing Address - Street 2:SUITE 46
Mailing Address - City:N PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3550
Mailing Address - Country:US
Mailing Address - Phone:561-290-7244
Mailing Address - Fax:561-629-7291
Practice Address - Street 1:1201 US HIGHWAY 1
Practice Address - Street 2:SUITE 46
Practice Address - City:N PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-3550
Practice Address - Country:US
Practice Address - Phone:561-290-7244
Practice Address - Fax:561-629-7291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7585111N00000X
FLME83846208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4402447OtherUNITED HEALTHCARE
FL3816001-00Medicaid
FLCH7585OtherSTATE LICENSE
FL4402447OtherUNITED HEALTHCARE
FL3816001-00Medicaid