Basic Information
| Provider Information | |||||||||
| NPI: | 1306889365 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEDICAL SPECIALISTS OF THE PALM BEACHES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7593 BOYNTON BEACH BLVD STE 220 | ||||||||
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| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334376162 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616497000 | ||||||||
| FaxNumber: | 8883152198 | ||||||||
| Practice Location | |||||||||
| Address1: | 10115 FOREST HILL BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | WELLINGTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334143104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619675033 | ||||||||
| FaxNumber: | 5619675424 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2006 | ||||||||
| LastUpdateDate: | 04/06/2022 | ||||||||
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| AuthorizedOfficialLastName: | WATERS | ||||||||
| AuthorizedOfficialFirstName: | CASEY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5616497000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 04/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RS0012X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | 207R00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RP1001X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RC0000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.