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General NPI Number Information
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NPI Number | 1487158929
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Entity Type | Organization
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Legal Business Name | J. WATERMAN & ASSOCIATES, LLC
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Dates
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Enumeration Date | 03/20/2018
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Last Update Date | 03/21/2018
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Provider Practice Location Address
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Address Line | 2543 BURNS RD
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-5204
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Country | US
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Telephone | 561-308-8086
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Fax |
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Provider Business Mailing Address
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Address Line | 729 CHARLESTOWN CIR
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-3428
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Country | US
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Telephone |
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Fax | 561-622-2764
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | VICKI WATERMAN
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Credential |
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Telephone | 561-308-8086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | OS5237
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License Number State |
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