Provider Demographics
NPI:1679316178
Name:T-UP MEN'S HEALTH AND WELLNESS CENTERS
Entity type:Organization
Organization Name:T-UP MEN'S HEALTH AND WELLNESS CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DNP FNP-BC
Authorized Official - Phone:561-855-4644
Mailing Address - Street 1:4362 NORTHLAKE BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-6269
Mailing Address - Country:US
Mailing Address - Phone:561-707-8777
Mailing Address - Fax:561-429-4633
Practice Address - Street 1:4362 NORTHLAKE BLVD STE 208
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-6269
Practice Address - Country:US
Practice Address - Phone:561-707-8777
Practice Address - Fax:561-429-4633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty