Provider Demographics
NPI:1487110995
Name:EVERGLADES COLLEGE INC
Entity type:Organization
Organization Name:EVERGLADES COLLEGE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:BERARDINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-776-4476
Mailing Address - Street 1:2085 VISTA PARKWAY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411
Mailing Address - Country:US
Mailing Address - Phone:561-471-6000
Mailing Address - Fax:561-471-7849
Practice Address - Street 1:2085 VISTA PARKWAY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411
Practice Address - Country:US
Practice Address - Phone:561-471-6000
Practice Address - Fax:561-471-7849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-20
Last Update Date:2023-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty