Healthcare Provider Details

I. General information

NPI: 1285888388
Provider Name (Legal Business Name): PLATINUM EAR, NOSE, AND THROAT, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2008
Last Update Date: 03/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13660 JOG RD SUITE 3
DELRAY BEACH FL
33446-3806
US

IV. Provider business mailing address

13660 JOG RD SUITE 3
DELRAY BEACH FL
33446-3806
US

V. Phone/Fax

Practice location:
  • Phone: 561-495-2002
  • Fax:
Mailing address:
  • Phone: 561-495-2002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberOS8153
License Number StateFL

VIII. Authorized Official

Name: DR. TODD I PARNES
Title or Position: OWNER
Credential: D.O
Phone: 561-495-2002