Healthcare Provider Details

I. General information

NPI: 1417204835
Provider Name (Legal Business Name): PHYSICIANS GROUP OF DELRAY, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2012
Last Update Date: 10/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 PALM TRL
DELRAY BEACH FL
33483-5847
US

IV. Provider business mailing address

1177 GEORGE BUSH BLVD STE 400
DELRAY BEACH FL
33483-7239
US

V. Phone/Fax

Practice location:
  • Phone: 800-990-0340
  • Fax:
Mailing address:
  • Phone: 800-990-0340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State

VIII. Authorized Official

Name: THOMAS BELEY
Title or Position: PRESIDENT
Credential: PH.D., LCSW
Phone: 800-990-0340