Healthcare Provider Details

I. General information

NPI: 1114757044
Provider Name (Legal Business Name): CMLA MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2024
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 S MILITARY TRL STE C
WEST PALM BEACH FL
33415-4600
US

IV. Provider business mailing address

1217 S MILITARY TRL STE C
WEST PALM BEACH FL
33415-4600
US

V. Phone/Fax

Practice location:
  • Phone: 561-342-5000
  • Fax:
Mailing address:
  • Phone: 561-342-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: RICARDO A MARTINEZ
Title or Position: MANAGER
Credential: NHA
Phone: 786-423-9423