Provider Demographics
NPI:1144058306
Name:PRIORITY PEDIATRICS OF THE PALM BEACHES LLC
Entity type:Organization
Organization Name:PRIORITY PEDIATRICS OF THE PALM BEACHES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:CORINNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTHAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-383-4668
Mailing Address - Street 1:3047 S DIXIE HWY APT 501
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33405-1567
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3047 S DIXIE HWY APT 501
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405-1567
Practice Address - Country:US
Practice Address - Phone:561-840-5950
Practice Address - Fax:561-916-3820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty