Provider Demographics
NPI:1770802175
Name:PGA MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:PGA MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:QUARTELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-625-5556
Mailing Address - Street 1:7100 FAIRWAY DR STE 33
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-3782
Mailing Address - Country:US
Mailing Address - Phone:561-625-5556
Mailing Address - Fax:
Practice Address - Street 1:7100 FAIRWAY DR STE 33
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-3782
Practice Address - Country:US
Practice Address - Phone:561-625-5556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7713111N00000X
FLME-98041207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty