Provider Demographics
NPI:1821412909
Name:LIFESTYLE MEDICINE SPECIALISTS OF PALM BEACH LLC
Entity Type:Organization
Organization Name:LIFESTYLE MEDICINE SPECIALISTS OF PALM BEACH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:GIOVANELLI PORRATA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-318-3727
Mailing Address - Street 1:3319 S STATE ROAD 7 STE 212
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33449-8146
Mailing Address - Country:US
Mailing Address - Phone:561-318-3727
Mailing Address - Fax:561-828-3254
Practice Address - Street 1:3319 STATE ROAD 7
Practice Address - Street 2:SUITE 212
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33449-8094
Practice Address - Country:US
Practice Address - Phone:561-318-3727
Practice Address - Fax:561-828-3254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty