Provider Demographics
NPI:1699214023
Name:J&K MEDICAL CENTER OF PALM BEACH INC.
Entity Type:Organization
Organization Name:J&K MEDICAL CENTER OF PALM BEACH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEH-NAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-640-3986
Mailing Address - Street 1:4047 OKEECHOBEE BLVD
Mailing Address - Street 2:SUITE # 113
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3239
Mailing Address - Country:US
Mailing Address - Phone:561-640-3986
Mailing Address - Fax:
Practice Address - Street 1:4047 OKEECHOBEE BLVD
Practice Address - Street 2:SUITE #113
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3239
Practice Address - Country:US
Practice Address - Phone:561-640-3986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1712171100000X
FLAP1865171100000X
FLAP3631171100000X
FLAP308171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty