Healthcare Provider Details
I. General information
NPI: 1871825372
Provider Name (Legal Business Name): CENTRAL PALM BEACH PHYSICIANS & URGENT CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/08/2010
Last Update Date: 01/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8200 OKEECHOBEE BLVD
WEST PALM BEACH FL
33411-2003
US
IV. Provider business mailing address
4623 FOREST HILL BLVD SUITE 101
WEST PALM BEACH FL
33415-9120
US
V. Phone/Fax
- Phone: 561-964-1111
- Fax: 561-967-3144
- Phone: 561-966-7194
- Fax: 561-966-7191
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | HCC5777 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
RUSS
M
SEGER
Title or Position: CEO / PRESIDENT
Credential: DC
Phone: 561-967-8888