Active NPI
Diverse Medical Care LLC
- Pain Medicine Physician
- Boynton Beach, FL
National Provider Identifier
1639434038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine Physician
- License
- PMC 1223
- 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, 2012
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryLocations
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.