Provider Demographics
NPI:1336397066
Name:DIGESTIVE CENTER OF THE PALM BEACHES
Entity Type:Organization
Organization Name:DIGESTIVE CENTER OF THE PALM BEACHES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:
Authorized Official - Last Name:SENZATIMORE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:561-659-5466
Mailing Address - Street 1:PO BOX 1695
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33402-1695
Mailing Address - Country:US
Mailing Address - Phone:561-659-5466
Mailing Address - Fax:
Practice Address - Street 1:1117 N OLIVE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3520
Practice Address - Country:US
Practice Address - Phone:561-659-5466
Practice Address - Fax:561-659-5493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-06
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10D0958176OtherCLIA