Advanced Breast Care of the Palm Beaches, PA.

Organization Active NPI Surgery Physician · Wellington, FL

NPI 1780906909 · NPPES record last updated Aug 24, 2010

Key facts

NPI
1780906909
Entity type
Organization (NPI type 2)
Primary specialty
Surgery Physician 208600000X
License
ME78137 (FL)
Legal business name
ADVANCED BREAST CARE OF THE PALM BEACHES, PA.
Practice address
12160 S Shore Blvd
Suite 103
Wellington, FL 33414-6269
Phone
(561) 798-7494
Fax
(978) 327-7952
NPI assigned
Feb 16, 2010
Organization subpart
No

Authorized official

Name
Dr. Kathleen E Minnick, M.D.
Title
Owner
Phone
(561) 798-7494

National Provider Directory

Locations

125 S State Road 7
Ste 104363
Wellington, FL 33414

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208600000X ME78137 FL Yes

Addresses

Primary practice location

12160 S Shore Blvd
Suite 103
Wellington, FL 33414-6269

Mailing address

125 S State Road 7
Suite 104-363
Wellington, FL 33414-4385
Phone (561) 798-7494

Other identifiers

IdentifierTypeStateIssuer
05-27-2010OtherFLCIGNA
05-15-2010OtherFLGHI
07-06-2005OtherFLAVMED
03-01-2010OtherFLMEDICARE
03-31-2005OtherFLBCBS
02-04-2010OtherFLUNITED
04-01-2010OtherFLAETNA

Other providers in Wellington, FL

All providers in Wellington, FL · Surgery Physician in Florida

Sources for this page

Verify at the official NPI Registry.