Provider Demographics
NPI:1437360419
Name:NORTHERN MEDICAL AND HOLISTIC CENTER CORP
Entity type:Organization
Organization Name:NORTHERN MEDICAL AND HOLISTIC CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DORIT
Authorized Official - Middle Name:
Authorized Official - Last Name:YABROV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-423-0800
Mailing Address - Street 1:PO BOX 7485
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34287-0485
Mailing Address - Country:US
Mailing Address - Phone:941-423-0800
Mailing Address - Fax:
Practice Address - Street 1:5400 BISCAYNE DRIVE
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287
Practice Address - Country:US
Practice Address - Phone:941-423-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJME93717207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty