Eleanor Theobald, PA-C

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

PA9116006 Issued in FL

Practice address

1010 S Federal Hwy Ste 1010
Delray Beach, FL 33483-5132

Phone

(561) 413-9511

NPI assigned

Apr 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1587686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1124648639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 NE 6TH ST UNIT 334",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333046407",
            "telephone_number": "443-837-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S FEDERAL HWY STE 1010",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334835132",
            "telephone_number": "561-413-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOBALD",
        "first_name": "ELEANOR",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "PA9116006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Toby Center for Family Transitions, Inc.
• The Villa of Delray LLC
• The Wellness Center Delray Beach
• Angelina S The, MD
• Gertie Marie Thelemaque, APRN, FNP-BC
• Therapeutic Insights
• Therapy by the Sea, LLC
• Therapy Cove
• Therapy Solutions Inc
• There'S a Way LLC

• Plastic Surgery Physician in Delray Beach, FL
• Providers in Delray Beach, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.