Provider Demographics
NPI:1003183930
Name:DR. CAROLYN HOUSS, MEDICAL DECISION ASSOCIATES,P.A.
Entity type:Organization
Organization Name:DR. CAROLYN HOUSS, MEDICAL DECISION ASSOCIATES,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOUSS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-626-6560
Mailing Address - Street 1:3345 BURNS RD
Mailing Address - Street 2:STE 101
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4324
Mailing Address - Country:US
Mailing Address - Phone:561-622-2022
Mailing Address - Fax:561-622-6775
Practice Address - Street 1:3345 BURNS RD
Practice Address - Street 2:STE 101
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4324
Practice Address - Country:US
Practice Address - Phone:561-622-2022
Practice Address - Fax:561-622-6775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-21
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS5563207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGP533AMedicare PIN
FLE73494Medicare UPIN
FL80111ZMedicare PIN