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General NPI Number Information
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NPI Number | 1114520673
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Entity Type | Organization
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Legal Business Name | PREMIER MEDICAL CENTER OF BOYNTON BEACH
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Dates
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Enumeration Date | 11/18/2020
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 326 W BOYNTON BEACH BLVD
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-4025
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Country | US
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Telephone | 561-767-8230
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Fax | 561-767-8231
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Provider Business Mailing Address
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Address Line | 326 W BOYNTON BEACH BLVD
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-4025
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Country | US
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Telephone | 561-767-8230
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Fax | 561-767-8231
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Authorized Official
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Title or Position | CEO
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Name | DR. MONICA DESHAUN ROUNDTREE CLECKLEY
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Credential | DNP, AAPRN
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Telephone | 561-767-8230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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