ACTIVE HEALTH CLINIC LLC – NPI #1417767518
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

ACTIVE HEALTH CLINIC LLC is a provider located in VERO BEACH, FL. NPPES has assigned the NPI number 1417767518 to ACTIVE HEALTH CLINIC LLC on January 10, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. This provider is also associated with 2 additional names listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice. Bear in mind that having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

The NPI profile was last updated on Jan 27, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ACTIVE HEALTH CLINIC LLC below.

NPI Profile for
ACTIVE HEALTH CLINIC LLC

NPI Number
1417767518
Enumeration Date

(more than a year ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ACTIVE HEALTH CLINIC LLC
Other name(s)
All associated names:

Doing Business As (dba)
ACTIVE HEALTH CLINIC
Primary location
1948 OCEAN RIDGE CIR
VERO BEACH, FL 32963-2730
Phone: (415) 279-0947 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
KASSRA MICHAEL KHAZALPOUR
PRESIDENT
Phone: (415) 279-0947
Updated
Certification Date
Jan 27, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.