Provider Demographics
NPI:1902159544
Name:CENTRAL PALM BEACH PHYSICIANS & URGENT CARE, INC.
Entity Type:Organization
Organization Name:CENTRAL PALM BEACH PHYSICIANS & URGENT CARE, INC.
Other - Org Name:MEDICAL CENTER OF THE PALM BEACHES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-967-8888
Mailing Address - Street 1:4623 FOREST HILL BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-7469
Mailing Address - Country:US
Mailing Address - Phone:561-967-8888
Mailing Address - Fax:561-641-8303
Practice Address - Street 1:7000 W CAMINO REAL
Practice Address - Street 2:SUITE 210
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5532
Practice Address - Country:US
Practice Address - Phone:561-964-1111
Practice Address - Fax:561-967-3144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5626111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty