1538481098 NPI number — PALM BEACH PRIMARY CARE & AESTHETICS

Table of content: MS. NATALIE JAYNE RICHARDS RN (NPI 1124605522)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538481098 NPI number — PALM BEACH PRIMARY CARE & AESTHETICS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PALM BEACH PRIMARY CARE & AESTHETICS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538481098
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/24/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6685 FOREST HILL BLVD
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
GREENACRES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33413-3358
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-432-5101
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6685 FOREST HILL BLVD
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
GREENACRES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33413-3358
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-432-5101
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/24/2010

Additional Information

Authorized Official

Authorized Official Last Name:
HAMILTON
Authorized Official First Name:
STEPHANIE
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
561-432-5101

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  PA9101160 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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