NPIMap

Organization Active NPI

Palm Beach Brain and Spine, LLC

  • Neurological Surgery Physician
  • Wellington, FL
National Provider Identifier
1861658510
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
PALM BEACH BRAIN AND SPINE, LLC
Practice address
1447 Medical Park Blvd
Suite 101
Wellington, FL 33414-3164
Phone
(561) 844-0120
Fax
(561) 800-1074
NPI assigned
Aug 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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

Authorized official

Name
Dr. Amos O Dare, MD
Title
Medical Director
Phone
(561) 844-0120

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

1447 Medical Park Blvd
Suite 101
Wellington, FL 33414-3164

Mailing address

1447 Medical Park Blvd
Suite 101
Wellington, FL 33414-3164
Phone (561) 844-0120

National Provider Directory

National Provider Directory
Tax ID family
Palm Beach Brain and Spine LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1217548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1861658510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 MEDICAL PARK BLVD",
            "address_2": "SUITE 101",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143164",
            "telephone_number": "561-844-0120",
            "fax_number": "561-800-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1447 MEDICAL PARK BLVD",
            "address_2": "SUITE 101",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143164",
            "telephone_number": "561-844-0120",
            "fax_number": "561-800-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH BRAIN AND SPINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-01",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "DARE",
        "authorized_official_first_name": "AMOS",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "561-844-0120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.

Verify at the official NPI Registry.