Provider Demographics
NPI:1740244896
Name:CARDIOVASCULAR MEDICAL SPECIALISTS OF THE PALM BEACHES PA
Entity type:Organization
Organization Name:CARDIOVASCULAR MEDICAL SPECIALISTS OF THE PALM BEACHES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-627-3130
Mailing Address - Street 1:PO BOX 31448
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33420-1448
Mailing Address - Country:US
Mailing Address - Phone:561-627-3130
Mailing Address - Fax:561-627-8971
Practice Address - Street 1:500 UNIVERSITY BOULEVARD
Practice Address - Street 2:SUITE 208
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458
Practice Address - Country:US
Practice Address - Phone:561-627-3130
Practice Address - Fax:561-627-8971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0047083207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21208Medicare ID - Type Unspecified