Provider Demographics
NPI:1871184267
Name:NUAGE MEDICAL LLC
Entity Type:Organization
Organization Name:NUAGE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRITZ
Authorized Official - Middle Name:
Authorized Official - Last Name:PAMPHILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-951-1002
Mailing Address - Street 1:931 VILLAGE BLVD STE 905-125
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-1803
Mailing Address - Country:US
Mailing Address - Phone:561-951-1002
Mailing Address - Fax:
Practice Address - Street 1:51 E BLUE HERON BLVD
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-4540
Practice Address - Country:US
Practice Address - Phone:561-951-1002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center