Healthcare Provider Details

I. General information

NPI: 1619280591
Provider Name (Legal Business Name): CRITICAL CARE ASSOCIATES OF SOUTH FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2010
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MEADOWS ROAD ATTN: MEDICAL STAFF OFFICE INTENSIVIST PROGRAM
BOCA RATON FL
33486
US

IV. Provider business mailing address

PO BOX 810097
BOCA RATON FL
33481-0097
US

V. Phone/Fax

Practice location:
  • Phone: 561-939-0200
  • Fax: 561-939-0274
Mailing address:
  • Phone: 561-939-0200
  • Fax: 561-939-0274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME85992
License Number StateFL

VIII. Authorized Official

Name: DR. RALPH PALUMBO
Title or Position: MANAGER
Credential: MD
Phone: 561-939-0200