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General NPI Number Information
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NPI Number | 1285670141
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE PRACTITIONERS OF WEST PALM BEACH
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 200 S ROSEMARY AVE
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-5746
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Country | US
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Telephone | 561-832-2100
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Fax | 561-832-2030
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Provider Business Mailing Address
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Address Line | 200 S ROSEMARY AVE
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-5746
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Country | US
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Telephone | 561-832-2100
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Fax | 561-832-2030
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Authorized Official
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Title or Position | OWNER
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Name | INGRID METZLER
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Credential |
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Telephone | 561-832-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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