Basic Information
| Provider Information | |||||||||
| NPI: | 1134166218 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PRESS | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7593 BOYNTON BEACH BLVD | ||||||||
| Address2: | SUITE 280 | ||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334376154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617335888 | ||||||||
| FaxNumber: | 8887145190 | ||||||||
| Practice Location | |||||||||
| Address1: | 6056 BOYNTON BEACH BLVD STE 215 | ||||||||
| Address2: | |||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334373500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617335888 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2006 | ||||||||
| LastUpdateDate: | 04/04/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | ME66510 | FL | Y | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | P00443890 | 01 | FL | MEDICARE RAIL ROAD | OTHER | 60412 | 01 | FL | NEIGHBORHOOD HEALTH | OTHER | 375612200 | 05 | FL | MEDICAID | 09230 | 01 | FL | HEALTHEASE | OTHER | 25481 | 01 | FL | BCBS | OTHER | 4502111 | 01 | FL | AETNA | OTHER |