| Palm Beach Wellness Llc | |
|
2645 N Federal Hwy Ste 120 Delray Beach FL 33483-6100 | |
| (561) 740-2004 | |
| Not Available |
| Full Name | Palm Beach Wellness Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2645 N Federal Hwy, Delray Beach, Florida |
| Authorized Official Name and Position | Christine Shim (MANAGER) |
| Authorized Official Contact | 5617402004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Palm Beach Wellness Llc 2645 N Federal Hwy Ste 120 Delray Beach FL 33483-6100 Ph: (561) 740-2004 | Palm Beach Wellness Llc 2645 N Federal Hwy Ste 120 Delray Beach FL 33483-6100 Ph: (561) 740-2004 |
| NPI Number | 1376086082 |
|---|---|
| Provider Enumeration Date | 11/29/2016 |
| Last Update Date | 11/29/2016 |
| Medicare PECOS PAC ID | 7113294869 |
|---|---|
| Medicare Enrollment ID | O20170530002559 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376086082 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | ME79337 (Florida) | Primary |
| Provider Name | Robert H Dudley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619973328 PECOS PAC ID: 1153361431 Enrollment ID: I20050505000741 |
| Provider Name | Christine Mimi Shim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396739439 PECOS PAC ID: 6204845688 Enrollment ID: I20060412000538 |
| Provider Name | Carole A Huber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306852116 PECOS PAC ID: 9133127871 Enrollment ID: I20061113000488 |
| Provider Name | Tahseen Nizam Silva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598178980 PECOS PAC ID: 5193045623 Enrollment ID: I20150522001136 |
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