Provider Demographics
NPI:1649260308
Name:DERMATOLOGY ASSOCIATES OF THE PALM BEACHES PLLC
Entity type:Organization
Organization Name:DERMATOLOGY ASSOCIATES OF THE PALM BEACHES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:ALEN
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-659-1510
Mailing Address - Street 1:120 BUTLER ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-6107
Mailing Address - Country:US
Mailing Address - Phone:561-659-1510
Mailing Address - Fax:561-659-0495
Practice Address - Street 1:120A BUTLER ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407
Practice Address - Country:US
Practice Address - Phone:561-659-1510
Practice Address - Fax:561-659-0495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-25
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty