Active NPI
Palm Beach Children's Associates, P.a.
- Pediatrics Physician
- West Palm Beach, FL
National Provider Identifier
1871714394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME 0055058
- Legal business name
- PALM BEACH CHILDREN'S ASSOCIATES, P.A.
- Practice address
- 1860 Forest Hill Blvd
Ste 102
West Palm Beach, FL 33406-6086 - Phone
- (561) 641-6000
- Fax
- (561) 641-6006
- NPI assigned
- May 1, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Conrad Valentino Wynne Jr., M.D.
- Title
- President
- Phone
- (561) 641-6000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME 0055058 | FL | Primary |
Addresses
Primary practice location
1860 Forest Hill Blvd
Ste 102
West Palm Beach, FL 33406-6086
Mailing address
1860 Forest Hill Blvd
Ste 102
West Palm Beach, FL 33406-6086
Phone (561) 641-6000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 015509 | Other | FL | AETNA |
| 38361 | Other | FL | BLUE CROSS BLUE SHIELD |
National Provider Directory
National Provider DirectoryLocations
1860 Forest Hill Blvd
Ste 102
West Palm Beach, FL 33406
Phone (561) 641-6000
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1871714394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1860 FOREST HILL BLVD",
"address_2": "STE 102",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334066086",
"telephone_number": "561-641-6000",
"fax_number": "561-641-6006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1860 FOREST HILL BLVD",
"address_2": "STE 102",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334066086",
"telephone_number": "561-641-6000",
"fax_number": "561-641-6006"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PALM BEACH CHILDREN'S ASSOCIATES, P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-01",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "WYNNE",
"authorized_official_first_name": "CONRAD",
"authorized_official_middle_name": "VALENTINO",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "561-641-6000",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "FL",
"license": "ME 0055058",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "015509",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "38361",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Palm Beach, FL
- Palm Beach Atlantic University (PBAU Sports Medicine)
- Palm Beach Brain and Spine LLC
- Palm Beach Cancer Institute LLC
- Palm Beach Cancer Institute LLC
- Palm Beach Cancer Institute, LLC.
- Palm Beach Children's Therapy, LLC
- Palm Beach Concierge Doctors
- Palm Beach Counseling and Behavioral Health, Inc.
- Palm Beach County Department of Community Services
- Palm Beach County Fire Fighters Health Clinic LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.