Provider Demographics
NPI:1376750687
Name:PALM BEACH MEDICAL CENTER INC
Entity Type:Organization
Organization Name:PALM BEACH MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:VALERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-690-1817
Mailing Address - Street 1:4394 PALM BEACH BLD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905
Mailing Address - Country:US
Mailing Address - Phone:239-690-1817
Mailing Address - Fax:239-690-1362
Practice Address - Street 1:4394 PALM BEACH BLD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-3446
Practice Address - Country:US
Practice Address - Phone:239-690-1817
Practice Address - Fax:239-690-1362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5625111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty