Provider Demographics
NPI:1700426020
Name:RED BRIDGE FAMILY & PSYCHIATRIC CARE, LLC
Entity Type:Organization
Organization Name:RED BRIDGE FAMILY & PSYCHIATRIC CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HEDEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESENDIEU
Authorized Official - Suffix:
Authorized Official - Credentials:MD & DNP
Authorized Official - Phone:561-715-4058
Mailing Address - Street 1:111 NE 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-3862
Mailing Address - Country:US
Mailing Address - Phone:561-715-4058
Mailing Address - Fax:850-633-2424
Practice Address - Street 1:1054 GATEWAY BLVD STE 109
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8309
Practice Address - Country:US
Practice Address - Phone:561-715-4058
Practice Address - Fax:850-633-2424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-14
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1972921781Medicaid