| Medvantage Primary Care | |
|
8198 S Jog Rd Ste 100 Boynton Beach FL 33472-2998 | |
| (561) 943-5519 | |
| (561) 423-3948 |
| Full Name | Medvantage Primary Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 8198 S Jog Rd Ste 100, Boynton Beach, Florida |
| Authorized Official Name and Position | Michael Louis Goldberg (PRESIDENT) |
| Authorized Official Contact | 5616908904 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medvantage Primary Care 22119 Martella Ave Boca Raton FL 33433-4661 Ph: (561) 690-8904 | Medvantage Primary Care 8198 S Jog Rd Ste 100 Boynton Beach FL 33472-2998 Ph: (561) 943-5519 |
| NPI Number | 1619736352 |
|---|---|
| Provider Enumeration Date | 03/15/2024 |
| Last Update Date | 05/05/2024 |
| Medicare PECOS PAC ID | 0345680443 |
|---|---|
| Medicare Enrollment ID | O20240506001379 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619736352 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael Louis Goldberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891140794 PECOS PAC ID: 2062757768 Enrollment ID: I20220410000127 |
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