MEDICARE: TAM OF BOYNTON BEACH

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1619130838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAM OF BOYNTON BEACH

Provider Business Mailing Address
First Line	:	3795 W BOYNTON BEACH BLVD
Second Line	:	SUITE A
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-4502
Country	:	US
Telephone Number	:	561-738-7900
Fax Number	:

Provider Business Practice Location Address
First Line	:	3795 W BOYNTON BEACH BLVD
Second Line	:	SUITE A
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-4502
Country	:	US
Telephone Number	:	561-738-7900
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MICHELE WELTER
Credential	:
Telephone Number	:	561-738-7900

Provider Enumeration Date	:	07/08/2008
Last Update Date	:	07/08/2008

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Directions to “TAM OF BOYNTON BEACH ” Practice Location

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