MEDICARE: PALM BEACH PEDIATRICS, LLC

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	208000000X	Pediatrics Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437955267
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALM BEACH PEDIATRICS, LLC

Provider Business Mailing Address
First Line	:	2000 PALM BEACH LAKES BLVD STE 901
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6506
Country	:	US
Telephone Number	:	561-509-5009
Fax Number	:

Provider Business Practice Location Address
First Line	:	5000-3 NORWOOD AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32208-5001
Country	:	US
Telephone Number	:	561-509-5009
Fax Number	:

Authorized Official
Title or Position	:	HEAD OF PRACTICE OPERATIONS
Name	:	ELIZABETH LARSEN
Credential	:
Telephone Number	:	319-936-6898

Provider Enumeration Date	:	02/21/2025
Last Update Date	:	12/11/2025

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