NPIMap

Organization Active NPI

Trudelldoctormd, LLC

  • Family Medicine Physician
  • Boynton Beach, FL
National Provider Identifier
1891433249
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TRUDELLDOCTORMD, LLC
Practice address
6080 Boynton Beach Blvd Ste 230
Boynton Beach, FL 33437-3588
Phone
(561) 807-7780
Fax
(866) 950-0144
NPI assigned
May 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Authorized official

Name
Marcia Rivera
Title
Practice Admin
Phone
(561) 254-8134

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

6080 Boynton Beach Blvd Ste 230
Boynton Beach, FL 33437-3588

Mailing address

6080 Boynton Beach Blvd Ste 230
Boynton Beach, FL 33437-3588
Phone (561) 807-7780

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1891433249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6080 BOYNTON BEACH BLVD STE 230",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373588",
            "telephone_number": "561-807-7780",
            "fax_number": "866-950-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 BOYNTON BEACH BLVD STE 230",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373588",
            "telephone_number": "561-807-7780",
            "fax_number": "866-950-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUDELLDOCTORMD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_title_or_position": "PRACTICE ADMIN",
        "authorized_official_telephone_number": "561-254-8134"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "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 May 25, 2022; 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.