Beachside Medical Care LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME57053 Issued in FL

Legal business name

BEACHSIDE MEDICAL CARE LLC

Practice address

1101 54TH St
West Palm Beach, FL 33407-2419

Phone

(561) 365-3758

Fax

(772) 448-4029

NPI assigned

Aug 1, 2016

Organization subpart

No

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

Authorized official

Name

Annemarie Sincavage

Title

Cfo

Phone

(561) 365-3758

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631577600000",
    "number": "1821541483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 54TH ST",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072419",
            "telephone_number": "561-365-3758",
            "fax_number": "772-448-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 54TH ST",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072419",
            "telephone_number": "561-365-3758",
            "fax_number": "772-448-4029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4005 N A1A",
            "address_purpose": "LOCATION",
            "city": "Hutchinson Island",
            "state": "FL",
            "postal_code": "349498524",
            "country_code": "US",
            "telephone_number": "561-365-3758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BEACHSIDE MEDICAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-01",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A",
        "authorized_official_last_name": "SINCAVAGE",
        "authorized_official_first_name": "ANNEMARIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "561-365-3758"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME57053",
            "primary": true
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "FL",
            "license": "ARNP3333482",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.