Healthcare Provider Details

I. General information

NPI: 1649822867
Provider Name (Legal Business Name): MEDICAL PARTNERS OF THE PALM BEACHES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 QUANTUM BLVD BLDG A
BOYNTON BEACH FL
33426-8627
US

IV. Provider business mailing address

2600 QUANTUM BLVD BLDG A
BOYNTON BEACH FL
33426-8627
US

V. Phone/Fax

Practice location:
  • Phone: 561-865-5896
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: PAMELA EGAN
Title or Position: MEMBER
Credential:
Phone: 561-212-1963