Provider Demographics
NPI:1124225750
Name:PALM BEACH EMERGENCY ASSOC. INC
Entity Type:Organization
Organization Name:PALM BEACH EMERGENCY ASSOC. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CASWELL
Authorized Official - Middle Name:J
Authorized Official - Last Name:RUMBALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-548-3549
Mailing Address - Street 1:PO BOX 850001
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32885-0332
Mailing Address - Country:US
Mailing Address - Phone:800-443-3672
Mailing Address - Fax:865-560-7310
Practice Address - Street 1:5301 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-1149
Practice Address - Country:US
Practice Address - Phone:561-548-3549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL74590Medicare ID - Type Unspecified