Provider Demographics
NPI:1700534088
Name:DEERFIELD HEALTH GROUP
Entity Type:Organization
Organization Name:DEERFIELD HEALTH GROUP
Other - Org Name:DEERFIELD HEALTH AND WELLNESS CENTER LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHEDELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NOEL
Authorized Official - Suffix:
Authorized Official - Credentials:MGR
Authorized Official - Phone:754-212-2668
Mailing Address - Street 1:4853 N DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-4861
Mailing Address - Country:US
Mailing Address - Phone:754-212-2668
Mailing Address - Fax:954-697-0313
Practice Address - Street 1:4853 N DIXIE HWY
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-4861
Practice Address - Country:US
Practice Address - Phone:754-212-2668
Practice Address - Fax:954-697-0313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-15
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty