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7240 7th Pl N West Palm Beach FL 33411-3801 | |
| (561) 969-6663 | |
| (561) 966-7760 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 7240 7th Pl N, West Palm Beach, Florida |
| Authorized Official Name and Position | Heather Coleman (OPERATIONS MANAGER) |
| Authorized Official Contact | 5619696663 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
7240 7th Pl N West Palm Beach FL 33411-3801 Ph: (561) 969-6663 | 7240 7th Pl N West Palm Beach FL 33411-3801 Ph: (561) 969-6663 |
| NPI Number | 1174949978 |
|---|---|
| Provider Enumeration Date | 03/17/2014 |
| Last Update Date | 11/21/2024 |
| Medicare PECOS PAC ID | 0143651679 |
|---|---|
| Medicare Enrollment ID | O20200515001723 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174949978 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | John F Villa |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457328205 PECOS PAC ID: 2365424207 Enrollment ID: I20050505000872 |
| Provider Name | Stephanie M Wise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508149048 PECOS PAC ID: 7416129481 Enrollment ID: I20111017000731 |
| Provider Name | Kerri S Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770871634 PECOS PAC ID: 3577799741 Enrollment ID: I20131118000245 |
| Provider Name | Dhrupa Desai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093115339 PECOS PAC ID: 4284958075 Enrollment ID: I20150127001813 |
| Provider Name | Lance Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124430152 PECOS PAC ID: 1951621879 Enrollment ID: I20150518000301 |
| Provider Name | Olivia D Odom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093162893 PECOS PAC ID: 3971899550 Enrollment ID: I20170811000372 |
| Provider Name | Amanda M Copeland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669912606 PECOS PAC ID: 7517290729 Enrollment ID: I20190603002110 |
| Provider Name | Jennifer M Milone |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770739880 PECOS PAC ID: 6103248026 Enrollment ID: I20200623002471 |
| Provider Name | Christina G Prose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871930743 PECOS PAC ID: 7315226412 Enrollment ID: I20200623002843 |
| Provider Name | Mary J Birse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700202058 PECOS PAC ID: 1456774066 Enrollment ID: I20200714002965 |
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