Healthcare Provider Details
I. General information
NPI: 1932422342
Provider Name (Legal Business Name): STEPHEN NEMEROFSKY MDPA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2010
Last Update Date: 03/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2000 LOWSON BLVD
DELRAY BEACH FL
33445-6008
US
IV. Provider business mailing address
1111 HYPOLUXO RD SUITE 107
LANTANA FL
33462-4271
US
V. Phone/Fax
- Phone: 561-454-1140
- Fax: 561-454-1144
- Phone: 561-586-3400
- Fax: 561-585-0079
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STEPHEN
LOUIS
NEMEROFSKY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 561-454-1140