Provider Demographics
NPI:1417175308
Name:COLONY SPRINGS MEDICAL CENTER OF PALM BCH, INC
Entity Type:Organization
Organization Name:COLONY SPRINGS MEDICAL CENTER OF PALM BCH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:JOHANNA
Authorized Official - Last Name:NEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-726-3721
Mailing Address - Street 1:130 JFK DR
Mailing Address - Street 2:SUITE # 131
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-1141
Mailing Address - Country:US
Mailing Address - Phone:561-439-7070
Mailing Address - Fax:561-967-3888
Practice Address - Street 1:130 JFK DR
Practice Address - Street 2:SUITE # 131
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-1141
Practice Address - Country:US
Practice Address - Phone:561-439-7070
Practice Address - Fax:561-967-3888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL051532902Medicaid
FL39364AMedicare UPIN