Organization

Obsidian Healthcare Llc

Internal Medicine Physician in Boynton Beach, FL(View on Map)

Legal Business Name

Obsidian Healthcare Llc

NPI Number

1447958699

NPI Type

Organization

Enumeration Date

02/17/2023

Specialties

(Taxonomies)

Code

207R00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

3379 W WOOLBRIGHT RD
3379 W WOOLBRIGHT RD

City

Boynton Beach
Boynton Beach

State

FL
FL

Postal Code

33436-7245
33436-7245

Country

US
US

Telephone Number

(561) 449-0066
(561) 449-0066

Authorized Official

Name

Mr. Jude Acloque

Title or Position

AUTHORIZED OFFICIAL

Telephone Number

(561) 443-0066

Identifiers

Identifier

ME133297

Identifier State

FL

Identifier Issuer

LICENSE

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 02/17/2023

Provider Address

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