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General NPI Number Information
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NPI Number | 1083683411
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Entity Type | Organization
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Legal Business Name | MEDICAL IPA OF THE PALM BEACHES
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1117 ROYAL PALM BEACH BLVD SUITE 102
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-1641
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Country | US
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Telephone | 561-790-2876
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Fax | 561-790-3884
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Provider Business Mailing Address
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Address Line | 1117 ROYAL PALM BEACH BLVD SUITE 102
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-1641
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Country | US
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Telephone | 561-790-2876
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Fax | 561-790-3884
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. ROBERT CAMERLINCK
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Credential |
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Telephone | 561-790-2876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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