# ROY J CACCIAGUIDA MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376814707
- **Authorized official:** DR. ROY J CACCIAGUIDA MD PA MD PA (DOCTOR/OWNER)
- **Authorized official phone:** (561) 832-3004

## Contact information

- **Practice address:** 1500 N DIXIE HWY STE 201, 201, WEST PALM BEACH, FL 33401-2716
- **Practice address phone:** (561) 832-3004
- **Practice address fax:** (561) 833-0460
- **Mailing address:** 7780 IRONHORSE BLVD, WEST PALM BEACH, FL 33412-2423
- **Mailing address phone:** (561) 832-3004
- **Mailing address fax:** (561) 833-0460

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | ME019768 | FL | Yes |

## Other

- **Enumeration date:** 01/17/2012
- **Last updated:** 10/23/2012