NPIMap

Organization Active NPI

Palm Medical Center Lakeland LLC

  • Internal Medicine Physician
  • Delray Beach, FL
National Provider Identifier
1710620885
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PALM MEDICAL CENTER LAKELAND LLC
Practice address
5258 Linton Blvd Ste 301
Delray Beach, FL 33484-6539
Phone
(561) 819-5447
Fax
(561) 819-5496
NPI assigned
Apr 18, 2022
Organization subpart
Yes
Parent organization
PALM MEDICAL CENTER LAKELAND LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Authorized official

Name
Carmel N Boswell
Title
Credentialing Manager
Phone
(813) 538-7880

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary
Clinic/Center 261Q00000X

Addresses

Primary practice location

5258 Linton Blvd Ste 301
Delray Beach, FL 33484-6539

Mailing address

5258 Linton Blvd Ste 301
Delray Beach, FL 33484-6539
Phone (561) 819-5447

Other identifiers 1

IdentifierTypeStateIssuer
276547100MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Palm Medical Center Lakelan36 organizations share this tax ID, including this one
Part of
Palm Medical Center Lakelan

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1710620885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5258 LINTON BLVD STE 301",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846539",
            "telephone_number": "561-819-5447",
            "fax_number": "561-819-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5258 LINTON BLVD STE 301",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846539",
            "telephone_number": "561-819-5447",
            "fax_number": "561-819-5496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM MEDICAL CENTER LAKELAND LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALM MEDICAL CENTER LAKELAND LLC",
        "enumeration_date": "2022-04-18",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "BOSWELL",
        "authorized_official_first_name": "CARMEL",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "813-538-7880"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276547100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

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