Healthcare Provider Details

I. General information

NPI: 1205686573
Provider Name (Legal Business Name): PALMS WEST HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 03/27/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13633 76TH RD N
WEST PALM BEACH FL
33412-2134
US

IV. Provider business mailing address

13633 76TH RD N
WEST PALM BEACH FL
33412-2134
US

V. Phone/Fax

Practice location:
  • Phone: 561-891-7597
  • Fax:
Mailing address:
  • Phone: 561-891-7597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: JASON KIMBRELL
Title or Position: CEO
Credential: CEO
Phone: 561-798-3300