Provider Demographics
NPI:1255006193
Name:PBC FIREFIGHTERS EMPLOYEE BENEFITS FUND
Entity Type:Organization
Organization Name:PBC FIREFIGHTERS EMPLOYEE BENEFITS FUND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-969-6663
Mailing Address - Street 1:7240 7TH PL N
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-3801
Mailing Address - Country:US
Mailing Address - Phone:561-969-6663
Mailing Address - Fax:
Practice Address - Street 1:3228 SW MARTIN DOWNS BLVD STE 33A
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-2679
Practice Address - Country:US
Practice Address - Phone:561-969-6663
Practice Address - Fax:561-721-3106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty