Provider Demographics
NPI:1093967689
Name:DEPARTMENT OF VETERANS AFFAIRS
Entity Type:Organization
Organization Name:DEPARTMENT OF VETERANS AFFAIRS
Other - Org Name:WEST PALM BEACH VA HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:ORTHOTIST (FITTER)
Authorized Official - Prefix:MS
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:BOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:COF
Authorized Official - Phone:561-422-6540
Mailing Address - Street 1:7305 N MILITARY TRL
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33410-7417
Mailing Address - Country:US
Mailing Address - Phone:561-422-6540
Mailing Address - Fax:561-422-8443
Practice Address - Street 1:7305 N MILITARY TRL
Practice Address - Street 2:PROSTHETIC DEPARTMENT
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-7417
Practice Address - Country:US
Practice Address - Phone:561-422-6540
Practice Address - Fax:561-422-8442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLC26364284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital