Healthcare Provider Details

I. General information

NPI: 1679735054
Provider Name (Legal Business Name): BETHESDA MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 S SEACREST BLVD
BOYNTON BEACH FL
33435-7934
US

IV. Provider business mailing address

2815 S SEACREST BLVD
BOYNTON BEACH FL
33435-7934
US

V. Phone/Fax

Practice location:
  • Phone: 561-737-7733
  • Fax: 561-733-5912
Mailing address:
  • Phone: 561-737-7733
  • Fax: 561-733-5912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. MARY JC PEED
Title or Position: ASST DIRECTOR
Credential:
Phone: 561-737-7733