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General NPI Number Information
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NPI Number | 1669607636
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Entity Type | Organization
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Legal Business Name | CAMBRIDGE MEDICAL GROUP OF WEST BOYNTON LLC
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Dates
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Enumeration Date | 05/20/2009
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 10817 S JOG RD SUITE 230
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City | BOYNTON BEACH
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State | FL
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Zip | 33437-0911
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Country | US
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Telephone | 561-634-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 2240 W WOOLBRIGHT RD SUITE 317
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-6332
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Country | US
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Telephone | 561-200-0047
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHARD LUCIBELLA
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Credential |
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Telephone | 561-634-8888
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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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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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