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Organization

ICONIC HEALTH LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SARAH RAVELLI ARNP (CEO, LEAD PRACTITIONER)
(330) 277-1131
Entity
Organization

Contact information

Practice address
1898 W HILLSBORO BLVD STE H, DEERFIELD BEACH, FL 33442-1434
(954) 571-9392
(954) 289-4888
Mailing address
1898 W HILLSBORO BLVD STE H, DEERFIELD BEACH, FL 33442-1434
(954) 571-9392
(954) 289-4888

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
363LA2200X
Adult Health Nurse Practitioner
Primary

Other

Enumeration date
05/10/2021
Last updated
05/19/2021
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