Provider Demographics
NPI:1457106569
Name:TRANSFORMATIONS CLINICAL ENTITY FLORIDA PLLC
Entity Type:Organization
Organization Name:TRANSFORMATIONS CLINICAL ENTITY FLORIDA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LANDON
Authorized Official - Middle Name:S
Authorized Official - Last Name:PRYOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-776-9555
Mailing Address - Street 1:2865 PGA BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2910
Mailing Address - Country:US
Mailing Address - Phone:561-776-9555
Mailing Address - Fax:
Practice Address - Street 1:2865 PGA BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-2910
Practice Address - Country:US
Practice Address - Phone:561-776-9555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty