MEDICARE: CENTRAL PALM BEACH PHYSICIANS & URGENT CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	24454	OTHER	FL	FLORIDA BLUE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417074691
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL PALM BEACH PHYSICIANS & URGENT CARE INC

Provider Business Mailing Address
First Line	:	4623 FOREST HILL BLVD
Second Line	:	SUITE 101
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-7469
Country	:	US
Telephone Number	:	561-967-8888
Fax Number	:	561-641-8303

Provider Business Practice Location Address
First Line	:	4623 FOREST HILL BLVD
Second Line	:	SUITE 101
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-7469
Country	:	US
Telephone Number	:	561-967-8888
Fax Number	:	561-641-8303

Authorized Official
Title or Position	:	OWNER
Name	:	RUSS M SEGER
Credential	:	D.C.
Telephone Number	:	561-967-8888

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	08/03/2017

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