# FAMILY MEDICAL GROUP WPB LLC

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

## Provider details

- **NPI number:** 1417832536
- **Authorized official:** ILEANA COLLADO (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (786) 971-8016

## Contact information

- **Practice address:** 1280 OLD CONGRESS AVE STE 217, WEST PALM BEACH, FL 33409-6377
- **Practice address phone:** (561) 316-0226
- **Mailing address:** 12391 SW 130TH ST, MIAMI, FL 33186-6208

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 08/07/2025
- **Last updated:** 08/07/2025