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General NPI Number Information
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NPI Number | 1619577798
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Entity Type | Organization
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Legal Business Name | PEDIATRIC PARTNERS OF PALM BEACH COUNTY
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Dates
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Enumeration Date | 10/28/2020
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 3401 PGA BLVD STE 300
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-2824
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Country | US
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Telephone | 561-741-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 PGA BLVD STE 300
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-2824
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REVENUE CYCLE SUPERVISOR
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Name | BETHANY LACROIX
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Credential |
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Telephone | 561-510-2356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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