Organization Active NPI

Aquarius Physicians Group

  • Addiction Medicine (Family Medicine) Physician
  • North Palm Beach, FL
National Provider Identifier
1396290409
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
AQUARIUS PHYSICIANS GROUP
Practice address
749 US Highway 1
Suite 210
North Palm Beach, FL 33408-4400
Phone
(561) 790-4177
NPI assigned
Aug 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Authorized official

Name
Robert Shatanoff
Title
General Partner
Phone
(561) 790-4177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X Primary

Addresses

Primary practice location

749 US Highway 1
Suite 210
North Palm Beach, FL 33408-4400

Mailing address

749 US Highway 1
Suite 210
North Palm Beach, FL 33408-4400
Phone (561) 790-4177

Other identifiers 1

IdentifierTypeStateIssuer
L16000150039OtherFLSTATE LICENSE NUMBER

National Provider Directory

National Provider Directory

Locations

749 US Highway 1
Ste 210
North Palm Beach, FL 33408
Phone (561) 790-4177

NPI Registry JSON

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471478400000",
    "number": "1396290409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "749 US HIGHWAY 1",
            "address_2": "SUITE 210",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334084400",
            "telephone_number": "561-790-4177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 US HIGHWAY 1",
            "address_2": "SUITE 210",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334084400",
            "telephone_number": "561-790-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AQUARIUS PHYSICIANS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-18",
        "last_updated": "2016-08-18",
        "status": "A",
        "authorized_official_last_name": "SHATANOFF",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "561-790-4177"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "L16000150039",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; 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.