Provider Demographics
NPI:1821439373
Name:PALM BEACH RESEARCH CENTER
Entity Type:Organization
Organization Name:PALM BEACH RESEARCH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PREZIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:N/A
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-689-0606
Mailing Address - Street 1:2277 PALM BEACH LAKES BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3401
Mailing Address - Country:US
Mailing Address - Phone:561-689-0606
Mailing Address - Fax:
Practice Address - Street 1:2277 PALM BEACH LAKES BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3401
Practice Address - Country:US
Practice Address - Phone:561-689-0606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81958261QR1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch