Healthcare Provider Details
I. General information
NPI: 1306889365
Provider Name (Legal Business Name): MEDICAL SPECIALISTS OF THE PALM BEACHES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/14/2006
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10115 FOREST HILL BLVD STE 200
WELLINGTON FL
33414-3104
US
IV. Provider business mailing address
7593 BOYNTON BEACH BLVD STE 220
BOYNTON BEACH FL
33437-6162
US
V. Phone/Fax
- Phone: 561-967-5033
- Fax: 561-967-5424
- Phone: 561-649-7000
- Fax: 888-315-2198
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RS0012X |
| Taxonomy | Sleep Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CASEY
WATERS
Title or Position: CEO
Credential:
Phone: 561-649-7000