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General NPI Number Information
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NPI Number | 1639365182
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Entity Type | Organization
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Legal Business Name | PALM BEACH PHYSICIANS, PA
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 09/07/2010
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Provider Practice Location Address
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Address Line | 3731 LAKE WORTH ROAD SUITE 1
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City | LAKE WORTH
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State | FL
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Zip | 33461
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Country | US
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Telephone | 561-967-0234
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Fax | 561-439-4833
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Provider Business Mailing Address
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Address Line | 3731 LAKE WORTH ROAD SUITE 1
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City | LAKE WORTH
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State | FL
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Zip | 33461
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Country | US
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Telephone | 561-967-0234
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Fax | 561-439-4833
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. BENEDICTO SANPEDRO
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Credential | M.D.
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Telephone | 561-967-1221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ARNP733712
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME29312
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License Number State | FL
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