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General NPI Number Information
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NPI Number | 1811473432
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Entity Type | Organization
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Legal Business Name | MY VISITING PROVIDER
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Dates
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Enumeration Date | 07/17/2018
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Last Update Date | 02/01/2019
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Provider Practice Location Address
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Address Line | 100 CENTURY BLVD STE 201
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City | WEST PALM BEACH
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State | FL
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Zip | 33417
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Country | US
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Telephone | 561-469-8042
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Fax | 561-469-8042
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Provider Business Mailing Address
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Address Line | 100 CENTURY BLVD STE 201
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-2262
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Country | US
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Telephone | 561-469-8042
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Fax | 561-469-8042
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Authorized Official
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Title or Position | PARTNER
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Name | KEVIN LEHMAN
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Credential | PT
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Telephone | 561-676-0320
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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 |
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License Number State |
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