Healthcare Provider Details

I. General information

NPI: 1760731186
Provider Name (Legal Business Name): CENTRAL PALM BEACH PHYSICIANS & URGENT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2012
Last Update Date: 09/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1335 S STATE ROAD 7
NORTH LAUDERDALE FL
33068-4023
US

IV. Provider business mailing address

4623 FOREST HILL BLVD SUITE 101
WEST PALM BEACH FL
33415-7469
US

V. Phone/Fax

Practice location:
  • Phone: 954-974-3111
  • Fax: 561-641-8303
Mailing address:
  • Phone: 561-967-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: RUSS SEGER
Title or Position: OWNER
Credential: D.C.
Phone: 561-967-8888