NPIMap

Organization Active NPI

Pediatric Dermatology of the Palm Beaches

  • Specialist
  • Palm Beach Gardens, FL
National Provider Identifier
1043601248
Registry record updated Feb 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME95018 Issued in FL
Legal business name
PEDIATRIC DERMATOLOGY OF THE PALM BEACHES
Practice address
3355 Burns Rd
Suite 204
Palm Beach Gardens, FL 33410-4353
Phone
(561) 804-7546
Fax
(561) 804-7543
NPI assigned
Feb 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Manju Elizabeth George, MDNPI 1912054446
Title
Owner
Phone
(561) 804-7546

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME95018 FL Primary

Addresses

Primary practice location

3355 Burns Rd
Suite 204
Palm Beach Gardens, FL 33410-4353

Mailing address

3355 Burns Rd
Suite 204
Palm Beach Gardens, FL 33410-4353
Phone (561) 804-7546

Other names 1

  • Manju Elizabeth George MD PLLC Doing business as

National Provider Directory

National Provider Directory

Locations

3355 Burns Rd
Ste 204
Palm Beach Gardens, FL 33410
Phone (561) 691-3500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423526400000",
    "number": "1043601248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 BURNS RD",
            "address_2": "SUITE 204",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104353",
            "telephone_number": "561-804-7546",
            "fax_number": "561-804-7543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 BURNS RD",
            "address_2": "SUITE 204",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104353",
            "telephone_number": "561-804-7546",
            "fax_number": "561-804-7543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DERMATOLOGY OF THE PALM BEACHES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-10",
        "last_updated": "2015-02-10",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "MANJU",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-804-7546",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME95018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manju Elizabeth George MD PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.