Provider Demographics
NPI:1942483334
Name:PALM BEACH CENTER OF HEALTH, INC.
Entity Type:Organization
Organization Name:PALM BEACH CENTER OF HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CERETHA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:THOMAS-MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:561-662-4647
Mailing Address - Street 1:PO BOX 10658
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33419-0658
Mailing Address - Country:US
Mailing Address - Phone:561-662-4647
Mailing Address - Fax:
Practice Address - Street 1:1361 AVENUE E STE C
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-6811
Practice Address - Country:US
Practice Address - Phone:561-662-4647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6147261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health