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ICONIC HEALTH LLC
NPI 1700460383
Nurse Practitioner - Adult Health in Deerfield Beach, FL

Active since May 10, 2021CLIA 10D0996766 · Waiver
1898 W HILLSBORO BLVD STE H, DEERFIELD BEACH, FL 33442(954) 571-9392(954) 289-4888 Get Directions Write a Review

NPPES record last updated: May 19, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 19, 2021, May 10, 2021 (2 updates tracked since 2021).

About Iconic Health Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ICONIC HEALTH LLC (NPI 1700460383) is a healthcare organization registered as an adult health in Deerfield Beach, Florida and active in the NPI registry since May 2021. The organization holds a CLIA Waiver certificate valid through February 26, 2028 and lists Sarah Ravelli, Ceo, Lead Practitioner, as its authorized official.

NPPES Registry Identity

NPI1700460383
Entity TypeOrganization
Primary Taxonomy363LA2200X
Legal Business NameICONIC HEALTH LLC
Location Address1898 W HILLSBORO BLVD STE HDeerfield Beach, FL 33442-1434
Mailing Address1898 W Hillsboro Blvd Ste HDeerfield Beach, FL 33442-1434 · (954) 571-9392 · Fax (954) 289-4888
Phone(954) 571-9392
Fax(954) 289-4888
Organization SubpartNo
Authorized OfficialSarah RavelliCeo, Lead Practitioner · (330) 277-1131
Enumeration DateMay 10, 2021
Last NPPES UpdateMay 19, 20212 updates tracked since enumeration
NPPES CertifiedMay 19, 2021
✔ NPI 1700460383 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal MedicineTaxonomy 207R00000X
1898 W HILLSBORO BLVD STE H, Deerfield Beach, FL 33442
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0996766

Iconic Health, LLC · Deerfield Beach, FL
Active · expires Feb 26, 2028
CLIA Number10D0996766
Laboratory TypePhysician Office
Certificate Effective DateFebruary 27, 2026
Certificate Expiration DateFebruary 26, 2028
Laboratory DirectorSarah O. Ravelli
Laboratory Phone(954) 571-9392
Laboratory LocationIconic Health, LLC1898 W Hillsboro Blvd Suite H, Deerfield Beach, FL 33442
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LOREN C HAYES ARNP
Nurse Practitioner (Acute Care)
1898 W HILLSBORO BLVD STE H
DEERFIELD BEACH, FL 33442
Broward County (954) 571-9392
INTEGRATED SERVICES OF SOUTH FLORIDA, INC.
Clinic/Center (Multi-Specialty)
1898 W HILLSBORO BLVD STE H
DEERFIELD BEACH, FL 33442
Broward County (954) 571-9392
SHIRLEY PATRICIA JIMENEZ PA
Physician Assistant
1898 W HILLSBORO BLVD STE H
DEERFIELD BEACH, FL 33442
Broward County (954) 571-9392
AMY ELIZABETH BINGAMAN OTR/L, CHT
Occupational Therapist (Hand)
1898 W HILLSBORO BLVD STE H
DEERFIELD BEACH, FL 33442
Broward County (954) 675-4357
SARAH RAVELLI ARNP-C
Nurse Practitioner (Adult Health)
1898 W HILLSBORO BLVD STE H
DEERFIELD BEACH, FL 33442
Broward County (954) 571-9392

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Iconic Health LLC's NPI number?

The NPI number for Iconic Health LLC is 1700460383. It was assigned to this organization in the NPPES registry on May 10, 2021.

Where is Iconic Health LLC located?

Iconic Health LLC is located at 1898 W Hillsboro Blvd Ste H, Deerfield Beach, FL 33442. The listed phone number is (954) 571-9392.

What is Iconic Health LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Does Iconic Health LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0996766) is associated with this NPI, valid through February 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Iconic Health LLC was last updated on May 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.