Healthcare Provider Details

I. General information

NPI: 1407785959
Provider Name (Legal Business Name): FLORIDA OCCUPATIONAL MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 CORPORATE WAY STE 108
WEST PALM BEACH FL
33407-2041
US

IV. Provider business mailing address

5601 CORPORATE WAY STE 108
WEST PALM BEACH FL
33407-2041
US

V. Phone/Fax

Practice location:
  • Phone: 561-420-0010
  • Fax:
Mailing address:
  • Phone: 561-420-0010
  • 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: BRENDON MAYER
Title or Position: MANAGER
Credential:
Phone: 561-420-0010