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General NPI Number Information
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NPI Number | 1447929468
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Entity Type | Organization
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Legal Business Name | PGIC HEALTHCARE INC
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Dates
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Enumeration Date | 09/13/2021
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 1495 FOREST HILL BLVD STE A3
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-6073
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Country | US
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Telephone | 561-270-0267
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Fax |
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Provider Business Mailing Address
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Address Line | 1860 TUCKER RD
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-6586
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Country | US
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Telephone | 786-567-2561
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Fax |
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Authorized Official
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Title or Position | OWNER/NURSE PRACTITIONER - FAMILY
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Name | PAULA MARIA GONZALEZ PEREZ
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Credential | NURSE PRACTITIONER
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Telephone | 786-567-2561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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