Basic Information
| Provider Information | |||||||||
| NPI: | 1629202775 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PREMIER MEDICAL CARE OF THE PALM BEACHES P A | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1937 | ||||||||
| Address2: | |||||||||
| City: | JUPITER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334681937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617482889 | ||||||||
| FaxNumber: | 5617481523 | ||||||||
| Practice Location | |||||||||
| Address1: | 3535 MILITARY TRL | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | JUPITER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334585009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617450072 | ||||||||
| FaxNumber: | 5617450074 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2009 | ||||||||
| LastUpdateDate: | 05/14/2009 | ||||||||
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| AuthorizedOfficialLastName: | BARLOW | ||||||||
| AuthorizedOfficialFirstName: | KAREN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT JUPITER PROFESSIONAL DEV | ||||||||
| AuthorizedOfficialTelephone: | 5617482889 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS6580 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.