Healthcare Provider Details

I. General information

NPI: 1659655371
Provider Name (Legal Business Name): FAMILY MEDICAL CARE OF PALM BEACH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2011
Last Update Date: 04/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10625 N MILITARY TRL SUITE 102
PALM BEACH GARDENS FL
33410-6564
US

IV. Provider business mailing address

10625 N MILITARY TRL SUITE 102
PALM BEACH GARDENS FL
33410-6564
US

V. Phone/Fax

Practice location:
  • Phone: 561-249-7626
  • Fax:
Mailing address:
  • Phone: 561-249-7626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NADER DARYAEE
Title or Position: PHYSICIAN / OWNER
Credential: MD
Phone: 561-249-7626