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Organization
LIFE MD
Active
Organization
LIFE MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK L VOLLARO (PRESIDENT)
(866) 954-8281
Entity
Organization
Contact information
Practice address
1901 S CONGRESS AVE, SUITE 150, BOYNTON BEACH, FL 33426-6556
(866) 954-8281
Mailing address
12718 OAK RUN CT, BOYNTON BEACH, FL 33436-6134
(866) 954-8281
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
08/21/2015
Last updated
08/21/2015
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