NPIMap

Organization Active NPI

Palm Beach Dermatology Institute, Inc.

  • Medical Specialty Clinic/Center
  • Boynton Beach, FL
National Provider Identifier
1780814103
Registry record updated Aug 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
ME54995 Issued in FL
Legal business name
PALM BEACH DERMATOLOGY INSTITUTE, INC.
Practice address
1760 N Congress Ave
Suite 200
Boynton Beach, FL 33426-8214
Phone
(561) 733-0077
Fax
(561) 733-0020
NPI assigned
Jul 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2009

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

Authorized official

Name
Dr. Hal Blake Ridgway, M.D.
Title
Pres
Phone
(561) 964-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X ME54995 FL Primary

Addresses

Primary practice location

1760 N Congress Ave
Suite 200
Boynton Beach, FL 33426-8214

Mailing address

1760 N Congress Ave
Suite 200
Boynton Beach, FL 33426-8214
Phone (561) 733-0077

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1248048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251158400000",
    "number": "1780814103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 N CONGRESS AVE",
            "address_2": "SUITE 200",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334268214",
            "telephone_number": "561-733-0077",
            "fax_number": "561-733-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 N CONGRESS AVE",
            "address_2": "SUITE 200",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334268214",
            "telephone_number": "561-733-0077",
            "fax_number": "561-733-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH DERMATOLOGY INSTITUTE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-20",
        "last_updated": "2009-08-25",
        "status": "A",
        "authorized_official_last_name": "RIDGWAY",
        "authorized_official_first_name": "HAL",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "561-964-7500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "ME54995",
            "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 Aug 25, 2009; 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.