Organization
THE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAVEDUL HAQUE II M.D. (OWNER)
(561) 627-0772
Entity
Organization
Contact information
Practice address
3370 BURNS RD, SUITE 103, PALM BEACH GARDENS, FL 33410-4327
(561) 627-0772
(888) 235-9876
Mailing address
319 SEPTEMBER ST, PALM BEACH GARDENS, FL 33410-1521
(561) 627-0772
(888) 235-9876
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME101767
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1453G
BCBS OF FL
FL
Enumeration date
03/11/2010
Last updated
03/11/2010
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