Provider Demographics
NPI:1164279352
Name:HEALTH BOOST SOLUTIONS
Entity type:Organization
Organization Name:HEALTH BOOST SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LARE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIEMBA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:772-359-6568
Mailing Address - Street 1:435 NW PRIMA VISTA BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-8731
Mailing Address - Country:US
Mailing Address - Phone:772-359-6568
Mailing Address - Fax:
Practice Address - Street 1:435 NW PRIMA VISTA BLVD
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-8731
Practice Address - Country:US
Practice Address - Phone:772-359-6568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-04
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty