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NPI Code Detail

MEDICARE: CRESTHAVEN MEDICAL CENTER

MEDICARE: CRESTHAVEN MEDICAL CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianME 0063531FL
2208000000XPediatrics PhysicianME71736FL

General Provider Information

NPI Number : 1184862039
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRESTHAVEN MEDICAL CENTER
Provider Business Mailing Address
First Line : 4320 FOREST HILL BLVD
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33406-5718
Country : US
Telephone Number : 561-964-8557
Fax Number :
Provider Business Practice Location Address
First Line : 4320 FOREST HILL BLVD
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33406-5718
Country : US
Telephone Number : 561-964-8557
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. ISAAC THOMPSON
Credential : MD
Telephone Number : 561-964-8557
Provider Enumeration Date : 01/30/2009
Last Update Date : 01/30/2009

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Directions to “CRESTHAVEN MEDICAL CENTER ” Practice Location

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