Provider Demographics
NPI:1043835259
Name:MYEMCDOC LLC
Entity Type:Organization
Organization Name:MYEMCDOC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:P
Authorized Official - Last Name:HOPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-683-4670
Mailing Address - Street 1:931 VILLAGE BLVD STE 135
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-1803
Mailing Address - Country:US
Mailing Address - Phone:561-683-4670
Mailing Address - Fax:561-686-8073
Practice Address - Street 1:931 VILLAGE BLVD STE 135
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-1803
Practice Address - Country:US
Practice Address - Phone:561-683-4670
Practice Address - Fax:561-686-8073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLNONEOtherEMC