Healthcare Provider Details

I. General information

NPI: 1285655175
Provider Name (Legal Business Name): INTERNAL MEDICINE ASSOCIATES OF THE PALM BEACHES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 10/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 NO. FLAGLER DRIVE SUITE 4300
WEST PALM BEACH FL
33401-3422
US

IV. Provider business mailing address

P.O. BOX 8296
WEST PALM BEACH FL
33407-0296
US

V. Phone/Fax

Practice location:
  • Phone: 561-366-8408
  • Fax: 561-366-8405
Mailing address:
  • Phone: 561-366-8408
  • Fax: 561-366-8405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME0065507
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DEAN S. MANN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 561-366-8408