Provider Demographics
NPI:1669607636
Name:CAMBRIDGE MEDICAL GROUP OF WEST BOYNTON LLC
Entity type:Organization
Organization Name:CAMBRIDGE MEDICAL GROUP OF WEST BOYNTON LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCIBELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-634-8888
Mailing Address - Street 1:2240 W WOOLBRIGHT RD
Mailing Address - Street 2:SUITE 317
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-6332
Mailing Address - Country:US
Mailing Address - Phone:561-200-0047
Mailing Address - Fax:
Practice Address - Street 1:10817 S JOG RD
Practice Address - Street 2:SUITE 230
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-0911
Practice Address - Country:US
Practice Address - Phone:561-634-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-20
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty