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General NPI Number Information
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NPI Number | 1205246188
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Entity Type | Organization
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Legal Business Name | DELRAY MEDICAL PHYSICIAN SERVICES LLC
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Dates
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Enumeration Date | 05/01/2014
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Last Update Date | 05/26/2016
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Provider Practice Location Address
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Address Line | 5352 LINTON BLVD
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City | DELRAY BEACH
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State | FL
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Zip | 33484-6514
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Country | US
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Telephone | 561-637-5354
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Fax | 561-637-5131
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Provider Business Mailing Address
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Address Line | 5352 LINTON BLVD
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City | DELRAY BEACH
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State | FL
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Zip | 33484-6514
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Country | US
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Telephone | 561-637-5354
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Fax | 561-637-5131
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Authorized Official
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Title or Position | SVP REGIONAL OPERATIONS, TENET
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Name | MS. MARSHA D POWERS
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Credential |
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Telephone | 954-509-3671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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