Provider Demographics
NPI:1639503378
Name:MEDICAL CLINICS P.A.
Entity Type:Organization
Organization Name:MEDICAL CLINICS P.A.
Other - Org Name:THE WELLNESS CENTER AT VERO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:NEMEROFSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-586-3400
Mailing Address - Street 1:1111 HYPOLUXO RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33462-4271
Mailing Address - Country:US
Mailing Address - Phone:561-586-3400
Mailing Address - Fax:561-585-0079
Practice Address - Street 1:1880 82ND AVE
Practice Address - Street 2:SUITE 202E
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966-6995
Practice Address - Country:US
Practice Address - Phone:772-257-6217
Practice Address - Fax:772-257-6219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-29
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 19488261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care