Organization
HEALTHY SENIOR MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER J PETTAS (CEO)
(561) 702-1299
Entity
Organization
Contact information
Practice address
515 E LAS OLAS BLVD STE 120, FORT LAUDERDALE, FL 33301-4261
(954) 787-8874
(954) 787-8875
Mailing address
2199 NE 5TH AVE, BOCA RATON, FL 33431-7610
(561) 702-1299
(561) 584-7505
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
11/12/2020
Last updated
11/12/2020
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