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	HCC5777	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	24454	OTHER	FL	FL BLUE GROUP #

General Provider Information

NPI Number	:	1871825372
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	:	33415-9120
Country	:	US
Telephone Number	:	561-966-7194
Fax Number	:	561-966-7191

Provider Business Practice Location Address
First Line	:	8200 OKEECHOBEE BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33411-2003
Country	:	US
Telephone Number	:	561-964-1111
Fax Number	:	561-967-3144

Authorized Official
Title or Position	:	CEO / PRESIDENT
Name	:	DR. RUSS M SEGER
Credential	:	DC
Telephone Number	:	561-967-8888

Provider Enumeration Date	:	02/08/2010
Last Update Date	:	01/11/2017

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