Provider Demographics
NPI:1417204835
Name:PHYSICIANS GROUP OF DELRAY, LLC.
Entity Type:Organization
Organization Name:PHYSICIANS GROUP OF DELRAY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BELEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW
Authorized Official - Phone:800-990-0340
Mailing Address - Street 1:1177 GEORGE BUSH BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-7239
Mailing Address - Country:US
Mailing Address - Phone:800-990-0340
Mailing Address - Fax:
Practice Address - Street 1:816 PALM TRL
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5847
Practice Address - Country:US
Practice Address - Phone:800-990-0340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty