Healthcare Provider Details

I. General information

NPI: 1184039448
Provider Name (Legal Business Name): PAUL SKOMRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2014
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 N FLAGLER DR STE 200
WEST PALM BEACH FL
33401-4006
US

IV. Provider business mailing address

625 N FLAGLER DR STE 200
WEST PALM BEACH FL
33401-4006
US

V. Phone/Fax

Practice location:
  • Phone: 561-268-2000
  • Fax:
Mailing address:
  • Phone: 561-268-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMT207399
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD60749667
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME139170
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: