Healthcare Provider Details

I. General information

NPI: 1649114240
Provider Name (Legal Business Name): MARY TWOFILES PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 45TH ST
WEST PALM BEACH FL
33407-2047
US

IV. Provider business mailing address

3406 DAVIE RD APT 506
DAVIE FL
33314-1635
US

V. Phone/Fax

Practice location:
  • Phone: 561-842-6141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number9121657
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: