Healthcare Provider Details

I. General information

NPI: 1003274713
Provider Name (Legal Business Name): BARRY A. GINSBERG,OD,PA DBA PALM RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2016
Last Update Date: 04/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 S SEACREST BLVD
BOYNTON BEACH FL
33435-6703
US

IV. Provider business mailing address

2501 S SEACREST BLVD
BOYNTON BEACH FL
33435-6703
US

V. Phone/Fax

Practice location:
  • Phone: 561-305-8572
  • Fax:
Mailing address:
  • Phone: 561-305-8572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. BARRY A GINSBERG
Title or Position: AUTHORIZED OFFICAL
Credential:
Phone: 561-703-8518