Healthcare Provider Details

I. General information

NPI: 1043206212
Provider Name (Legal Business Name): E-MED LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MEADOWS RD
BOCA RATON FL
33486-2304
US

IV. Provider business mailing address

PO BOX 947103
ATLANTA GA
30394-7103
US

V. Phone/Fax

Practice location:
  • Phone: 561-395-7100
  • Fax:
Mailing address:
  • Phone: 800-225-0953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: EVAN D GOLDSTEIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 561-309-7815