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General NPI Number Information
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NPI Number | 1710172929
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Entity Type | Organization
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Legal Business Name | PALM BEACH FAMILY MEDICAL ASSOCIATES INC
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 02/13/2008
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Provider Practice Location Address
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Address Line | 5700 LAKE WORTH RD STE 103
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City | GREENACRES
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State | FL
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Zip | 33463-4727
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Country | US
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Telephone | 561-649-7532
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Fax | 561-649-7535
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Provider Business Mailing Address
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Address Line | 5700 LAKE WORTH RD STE 103
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City | GREENACRES
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State | FL
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Zip | 33463-4727
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Country | US
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Telephone | 561-649-7532
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KATHLEEN S RATHBUN
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Credential | D O
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Telephone | 561-309-8112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | OS7267
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License Number State | FL
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