Healthcare Provider Details

I. General information

NPI: 1134941495
Provider Name (Legal Business Name): PRIME ACCESS MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 PALM BEACH LAKES BLVD STE 218A
WEST PALM BEACH FL
33409-3308
US

IV. Provider business mailing address

2300 PALM BEACH LAKES BLVD STE 218A
WEST PALM BEACH FL
33409-3308
US

V. Phone/Fax

Practice location:
  • Phone: 844-799-2213
  • Fax:
Mailing address:
  • Phone: 844-799-2213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JIMMY ADOLPHE
Title or Position: MANAGER
Credential:
Phone: 917-930-8845