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General NPI Number Information
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NPI Number | 1205163250
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Entity Type | Organization
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Legal Business Name | ROYAL PALM BEACH MEDICAL GROUP INC.
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Dates
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Enumeration Date | 11/12/2009
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Last Update Date | 07/09/2024
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Provider Practice Location Address
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Address Line | 11903 SOUTHERN BLVD SUITE 108
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-7644
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Country | US
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Telephone | 561-793-1475
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Fax | 561-793-1478
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Provider Business Mailing Address
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Address Line | 11903 SOUTHERN BLVD SUITE 108
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-7644
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Country | US
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Telephone | 561-793-1475
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Fax | 561-793-1478
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Authorized Official
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Title or Position | PRIMARY MANAGER
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Name | JEMIMA DORCIN
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Credential |
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Telephone | 561-793-1475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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