Healthcare Provider Details

I. General information

NPI: 1336843325
Provider Name (Legal Business Name): INTERNAL MEDICINE CARE OF THE PALM BEACHES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 03/15/2025
Certification Date: 03/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3345 BURNS RD STE 202
PALM BEACH GARDENS FL
33410-4305
US

IV. Provider business mailing address

3345 BURNS RD STE 202
PALM BEACH GARDENS FL
33410-4305
US

V. Phone/Fax

Practice location:
  • Phone: 954-638-8615
  • Fax: 954-635-5513
Mailing address:
  • Phone: 954-638-8615
  • Fax: 954-635-5513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL FITZALLEN AMBROSE
Title or Position: PD
Credential: MD
Phone: 954-638-8615