Provider Demographics
NPI:1871004010
Name:INTERNAL MEDICINE & GERIATRIC CONSULTANTS OF PALM BEACH COUNTY LLC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE & GERIATRIC CONSULTANTS OF PALM BEACH COUNTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HUGO
Authorized Official - Middle Name:
Authorized Official - Last Name:POLANCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-865-5151
Mailing Address - Street 1:16244 S MILITARY TRL STE 470
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6532
Mailing Address - Country:US
Mailing Address - Phone:561-865-5151
Mailing Address - Fax:
Practice Address - Street 1:16244 S MILITARY TRL STE 470
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6532
Practice Address - Country:US
Practice Address - Phone:561-865-5151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty