Healthcare Provider Details

I. General information

NPI: 1306172176
Provider Name (Legal Business Name): DOCTORS GROUP OF THE PALM BEACHES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2009
Last Update Date: 09/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 US HIGHWAY 1
N PALM BEACH FL
33408-4617
US

IV. Provider business mailing address

PO BOX 538130
ATLANTA GA
30353-8130
US

V. Phone/Fax

Practice location:
  • Phone: 561-465-1400
  • Fax: 561-465-1401
Mailing address:
  • Phone: 561-465-1400
  • Fax: 561-465-1401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DAVID HU
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 561-465-1082