Healthcare Provider Details

I. General information

NPI: 1962793281
Provider Name (Legal Business Name): CORINNE ERIN ALTHAUSER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2011
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S ROSEMARY AVE STE 204
WEST PALM BEACH FL
33401-6310
US

IV. Provider business mailing address

3047 S DIXIE HWY APT 502
WEST PALM BEACH FL
33405-1568
US

V. Phone/Fax

Practice location:
  • Phone: 615-840-5950
  • Fax: 954-405-8648
Mailing address:
  • Phone: 561-840-5950
  • Fax: 954-405-8648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS12769
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: