Provider Demographics
NPI:1528006954
Name:PALM BEACH EMERGENCY MEDICINE ASSOCIATES PL
Entity Type:Organization
Organization Name:PALM BEACH EMERGENCY MEDICINE ASSOCIATES PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CASWELL
Authorized Official - Middle Name:J
Authorized Official - Last Name:RUMBALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-548-3549
Mailing Address - Street 1:PO BOX 850001
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32885-0001
Mailing Address - Country:US
Mailing Address - Phone:800-443-3672
Mailing Address - Fax:865-560-7310
Practice Address - Street 1:5301 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-1149
Practice Address - Country:US
Practice Address - Phone:561-548-3549
Practice Address - Fax:561-548-3591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269351800Medicaid
FLDE1870OtherRRGA
FLK9270Medicare PIN