Advanced Medical Diamond Group, LLC
Organization Active NPI Family Medicine Physician · Delray Beach, FL
NPI 1619304573 · NPPES record last updated Oct 8, 2013
Key facts
- NPI
- 1619304573
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- ME113665 (FL)
- Legal business name
- ADVANCED MEDICAL DIAMOND GROUP, LLC
- Practice address
- 1055 S Congress Ave
Suite 1
Delray Beach, FL 33445-6001 - Phone
- (561) 278-9005
- Fax
- (561) 423-0800
- NPI assigned
- Oct 8, 2013
- Organization subpart
- No
Authorized official
- Name
- Daniel Charleston, D.C.
- Title
- Owner
- Phone
- (561) 278-9005
National Provider Directory
Locations
1055 S Congress Ave
Ste 1
Delray Beach, FL 33445
Phone (561) 278-9005
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | CH8492 | FL | |
| Family Medicine Physician |
207Q00000X | ME113665 | FL | Yes |
Addresses
Primary practice location
1055 S Congress Ave
Suite 1
Delray Beach, FL 33445-6001
Mailing address
1055 S Congress Ave
Suite 1
Delray Beach, FL 33445-6001
Phone (561) 278-9005
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All providers in Delray Beach, FL · Family Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.