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General NPI Number Information
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NPI Number | 1396517355
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Entity Type | Organization
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Legal Business Name | PALM BEACH JOINT REPLACEMENT PLLC
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Dates
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Enumeration Date | 10/24/2023
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Last Update Date | 03/25/2024
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Provider Practice Location Address
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Address Line | 108 INTRACOASTAL POINTE DR STE 200
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City | JUPITER
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State | FL
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Zip | 33477-5036
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Country | US
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Telephone | 561-900-7124
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Fax | 561-330-6606
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Provider Business Mailing Address
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Address Line | 108 INTRACOASTAL POINTE DR STE 200
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City | JUPITER
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State | FL
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Zip | 33477-5036
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Country | US
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Telephone | 561-900-7124
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Fax | 561-330-6606
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Authorized Official
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Title or Position | OWNER
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Name | VINCENT FOWBLE
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Credential | MD
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Telephone | 561-310-4563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number |
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License Number State |
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