Provider Demographics
NPI:1376581280
Name:HAMPTONS MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:HAMPTONS MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:V
Authorized Official - Last Name:CARIDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-368-2714
Mailing Address - Street 1:1590 NW 10TH AVE
Mailing Address - Street 2:SUITE #201
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1313
Mailing Address - Country:US
Mailing Address - Phone:561-368-2714
Mailing Address - Fax:561-368-9929
Practice Address - Street 1:1590 NW 10TH AVE
Practice Address - Street 2:SUITE #201
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1313
Practice Address - Country:US
Practice Address - Phone:561-368-2714
Practice Address - Fax:561-368-9929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME093459207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAA616Medicare PIN