Provider Demographics
NPI:1508416074
Name:DELRAY MEDICAL INSTITUTE INC
Entity Type:Organization
Organization Name:DELRAY MEDICAL INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIBERTO
Authorized Official - Middle Name:R
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-699-8526
Mailing Address - Street 1:190 CONGRESS PARK DR STE 180
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-4707
Mailing Address - Country:US
Mailing Address - Phone:561-699-8526
Mailing Address - Fax:
Practice Address - Street 1:190 CONGRESS PARK DR STE 180
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4707
Practice Address - Country:US
Practice Address - Phone:561-699-8526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-17
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty