Healthcare Provider Details

I. General information

NPI: 1124853122
Provider Name (Legal Business Name): LITTLE PALMS BY THE SEA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 09/09/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 INTRACOASTAL POINTE DR STE 200
JUPITER FL
33477-5024
US

IV. Provider business mailing address

116 INTRACOASTAL POINTE DR STE 200
JUPITER FL
33477-5024
US

V. Phone/Fax

Practice location:
  • Phone: 561-331-2928
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. YELA MONICA MARTINEZ-RUBIO
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 561-331-2928