Healthcare Provider Details

I. General information

NPI: 1083657795
Provider Name (Legal Business Name): MEDICAL SPECIALISTS OF THE PALM BEACHES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9868 S STATE ROAD 7 STE 325 BLDG B
BOYNTON BEACH FL
33472-4477
US

IV. Provider business mailing address

7593 BOYNTON BEACH BLVD STE 220
BOYNTON BEACH FL
33437-6162
US

V. Phone/Fax

Practice location:
  • Phone: 561-967-5033
  • Fax:
Mailing address:
  • Phone: 561-968-7968
  • Fax: 888-316-2198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: CASEY WATERS
Title or Position: CEO
Credential:
Phone: 561-649-7000