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Organization
J M PROVENZANO MD PA
Active
Organization
J M PROVENZANO MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH MICHAEL PROVENZANO M.D. (PRESIDENT)
(561) 736-7330
Entity
Organization
Contact information
Practice address
906 S FEDERAL HWY STE A, BOYNTON BEACH, FL 33435-5671
(561) 736-7330
(561) 736-7388
Mailing address
906 S FEDERAL HWY STE A, BOYNTON BEACH, FL 33435-5671
(561) 736-7330
(561) 736-7388
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
51311
FL
Other
Enumeration date
12/21/2012
Last updated
12/21/2012
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