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General NPI Number Information
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NPI Number | 1750723045
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE OF PALM BEACH LLC
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Dates
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Enumeration Date | 07/27/2013
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Last Update Date | 07/27/2013
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Provider Practice Location Address
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Address Line | 3347 STATE ROAD 7 SUITE 206
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City | WELLINGTON
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State | FL
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Zip | 33449-8095
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Country | US
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Telephone | 561-283-0381
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Fax | 561-434-3169
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Provider Business Mailing Address
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Address Line | 3347 STATE ROAD 7 SUITE 206
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City | WELLINGTON
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State | FL
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Zip | 33449-8095
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Country | US
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Telephone | 561-283-0381
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Fax | 561-434-3169
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MOHAMMAD YAQUB M
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Credential | MD
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Telephone | 561-283-0381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME99808
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License Number State | FL
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