MEDICARE: PRIMARY CARE MEDICAL ASSOCIATES, INC.

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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1306835855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMARY CARE MEDICAL ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	6056 BOYNTON BEACH BLVD
Second Line	:	SUITE 225
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3584
Country	:	US
Telephone Number	:	561-732-6322
Fax Number	:	561-739-9981

Provider Business Practice Location Address
First Line	:	6056 BOYNTON BEACH BLVD
Second Line	:	SUITE 225
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3584
Country	:	US
Telephone Number	:	561-732-6322
Fax Number	:	561-739-9981

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. PATRICK BIRMINGHAM
Credential	:
Telephone Number	:	615-373-7625

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	08/22/2020

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