Provider Demographics
NPI:1659649630
Name:ADVANCED HEALTHCARE OF THE PALM BEACHES, PLLC
Entity Type:Organization
Organization Name:ADVANCED HEALTHCARE OF THE PALM BEACHES, PLLC
Other - Org Name:ADVANCED HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:SLOSSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-296-1715
Mailing Address - Street 1:4640 HYPOLUXO RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-7534
Mailing Address - Country:US
Mailing Address - Phone:561-296-1715
Mailing Address - Fax:561-296-1716
Practice Address - Street 1:4640 HYPOLUXO RD
Practice Address - Street 2:SUITE 2
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-7534
Practice Address - Country:US
Practice Address - Phone:561-296-1715
Practice Address - Fax:561-296-1716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100049208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty