Healthcare Provider Details

I. General information

NPI: 1922237932
Provider Name (Legal Business Name): ROYAL PALM BEACH MEDICAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2009
Last Update Date: 07/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10151 ENTERPRISE CENTER BLVD STE 205
BOYNTON BEACH FL
33437-3759
US

IV. Provider business mailing address

106 PONCE DE LEON ST
ROYAL PALM BEACH FL
33411-1213
US

V. Phone/Fax

Practice location:
  • Phone: 954-533-8400
  • Fax: 954-533-8500
Mailing address:
  • Phone: 561-791-9090
  • Fax: 561-791-9071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN PAPA
Title or Position: PRESIDENT
Credential: D.C.
Phone: 561-791-9090