Healthcare Provider Details

I. General information

NPI: 1922089887
Provider Name (Legal Business Name): PALM BEACH HOSPITALISTS PROGRAM,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 S CONGRESS AVE
ATLANTIS FL
33462-1149
US

IV. Provider business mailing address

5301 S CONGRESS AVE
ATLANTIS FL
33462-1149
US

V. Phone/Fax

Practice location:
  • Phone: 561-588-4844
  • Fax: 561-588-3655
Mailing address:
  • Phone: 561-588-4844
  • Fax: 561-588-3655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. PATRICK BIRMINGHAM
Title or Position: DIRECTOR
Credential:
Phone: 615-373-7625