Provider Demographics
NPI:1952107781
Name:PALM BEACH PEDIATRICS, LLC
Entity type:Organization
Organization Name:PALM BEACH PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD OF PRACTICE OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LARSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-936-6898
Mailing Address - Street 1:2000 PALM BEACH LAKES BLVD STE 901
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6506
Mailing Address - Country:US
Mailing Address - Phone:561-509-5009
Mailing Address - Fax:
Practice Address - Street 1:7613 NW 57TH ST
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33351
Practice Address - Country:US
Practice Address - Phone:561-509-5009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-21
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty