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General NPI Number Information
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NPI Number | 1215226170
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Entity Type | Organization
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Legal Business Name | PALM MEDICAL OF SOUTH FLORIDA
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Dates
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Enumeration Date | 03/31/2011
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Last Update Date | 03/31/2011
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Provider Practice Location Address
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Address Line | 200 KNUTH RD SUITE 150
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-4629
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Country | US
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Telephone | 561-364-5600
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Fax | 561-364-4010
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Provider Business Mailing Address
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Address Line | 200 KNUTH RD SUITE 150
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-4629
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Country | US
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Telephone | 561-364-5600
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Fax | 561-364-4010
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STUART T LEWIS
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Credential | DO
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Telephone | 561-364-5600
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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 | OS7340
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License Number State | FL
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