Provider Demographics
NPI:1487194981
Name:TRAVEL MEDICINE & INFECTIOUS DISEASES OF THE PALM BEACHES LLC
Entity Type:Organization
Organization Name:TRAVEL MEDICINE & INFECTIOUS DISEASES OF THE PALM BEACHES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCOBEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-967-0101
Mailing Address - Street 1:10115 FOREST HILL BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3105
Mailing Address - Country:US
Mailing Address - Phone:561-967-0101
Mailing Address - Fax:561-967-6260
Practice Address - Street 1:5401 S CONGRESS AVE STE 201
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-6637
Practice Address - Country:US
Practice Address - Phone:561-967-0101
Practice Address - Fax:561-967-6260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-02
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0094948207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty