Provider Demographics
NPI:1851798664
Name:PALM CITY ENTERPRISES, LLC.
Entity Type:Organization
Organization Name:PALM CITY ENTERPRISES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-792-5270
Mailing Address - Street 1:118 FLACK ST
Mailing Address - Street 2:
Mailing Address - City:FALFURRIAS
Mailing Address - State:TX
Mailing Address - Zip Code:78355-4930
Mailing Address - Country:US
Mailing Address - Phone:956-792-5270
Mailing Address - Fax:210-881-6802
Practice Address - Street 1:118 FLACK ST
Practice Address - Street 2:
Practice Address - City:FALFURRIAS
Practice Address - State:TX
Practice Address - Zip Code:78355-4930
Practice Address - Country:US
Practice Address - Phone:956-792-5270
Practice Address - Fax:210-881-6802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty