Healthcare Provider Details

I. General information

NPI: 1770906406
Provider Name (Legal Business Name): CENTRAL PALM BEACH PHYSICIANS & URGENT CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2014
Last Update Date: 01/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 W CYPRESS CREEK RD SUITE C100
FORT LAUDERDALE FL
33309-1744
US

IV. Provider business mailing address

4623 FOREST HILL BLVD SUITE 101
WEST PALM BEACH FL
33415-9120
US

V. Phone/Fax

Practice location:
  • Phone: 954-974-3111
  • Fax: 954-974-6191
Mailing address:
  • Phone: 561-966-7194
  • Fax: 561-966-7191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH5626
License Number StateFL

VIII. Authorized Official

Name: RUSS M SEGER
Title or Position: CEO / PRESIDENT
Credential: DC
Phone: 561-967-8888