Organization Active NPI

Diverse Medical Care LLC

  • Pain Medicine Physician
  • Boynton Beach, FL
National Provider Identifier
1639434038
Registry record updated Jul 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
PMC 1223 Issued in FL
Legal business name
DIVERSE MEDICAL CARE LLC
Practice address
2310 SE 2ND St
Suite #2
Boynton Beach, FL 33435-7280
Phone
(561) 509-9382
Fax
(561) 509-9362
NPI assigned
Jul 11, 2012
Last updated
Jul 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2012

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

Authorized official

Name
Mary N Atalla
Title
Manager
Phone
(561) 509-9382

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X PMC 1223 FL Primary

Addresses

Primary practice location

2310 SE 2ND St
Suite #2
Boynton Beach, FL 33435-7280

Mailing address

4215 S Flagler Dr
West Palm Beach, FL 33405-2705
Phone (561) 509-9382

National Provider Directory

National Provider Directory

Locations

2310 SE 2nd St
Ste 2
Boynton Beach, FL 33435
Phone (561) 509-9382

NPI Registry JSON

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342051200000",
    "number": "1639434038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 S FLAGLER DR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334052705",
            "telephone_number": "561-509-9382",
            "fax_number": "561-509-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 SE 2ND ST",
            "address_2": "SUITE #2",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357280",
            "telephone_number": "561-509-9382",
            "fax_number": "561-509-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSE MEDICAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-11",
        "last_updated": "2012-07-12",
        "status": "A",
        "authorized_official_last_name": "ATALLA",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-509-9382"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "PMC 1223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; 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.