Provider Demographics
NPI:1598642092
Name:PRVNT LLC
Entity type:Organization
Organization Name:PRVNT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-755-1121
Mailing Address - Street 1:1107 TANGLED ORCHARD TRCE
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-1114
Mailing Address - Country:US
Mailing Address - Phone:347-439-0558
Mailing Address - Fax:
Practice Address - Street 1:11358 OKEECHOBEE BLVD STE 2
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-8723
Practice Address - Country:US
Practice Address - Phone:561-755-1121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty