Healthcare Provider Details

I. General information

NPI: 1205790946
Provider Name (Legal Business Name): PALM BEACH PATHOLOGY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21644 STATE ROAD 7
BOCA RATON FL
33428-1842
US

IV. Provider business mailing address

PO BOX 4454
WEST PALM BEACH FL
33402-4454
US

V. Phone/Fax

Practice location:
  • Phone: 561-488-8172
  • Fax:
Mailing address:
  • Phone: 561-642-2998
  • Fax: 561-642-2998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS A BOLTON
Title or Position: PRESIDENT
Credential: MD
Phone: 561-659-0770