Healthcare Provider Details

I. General information

NPI: 1750324455
Provider Name (Legal Business Name): MEDICAL SPECIALISTS OF THE PALM BEACHES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 04/06/2022
Certification Date: 04/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12989 SOUTHERN BLVD STE 204
LOXAHATCHEE FL
33470-9291
US

IV. Provider business mailing address

7593 BOYNTON BEACH BLVD STE 220
BOYNTON BEACH FL
33437-6162
US

V. Phone/Fax

Practice location:
  • Phone: 561-784-5885
  • Fax: 561-963-0509
Mailing address:
  • Phone: 561-649-7000
  • Fax: 888-316-2198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CASEY WATERS
Title or Position: CEO
Credential:
Phone: 561-649-7000