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Organization
PALM MEDICAL CENTER LAKELAND LLC
Active
Organization
PALM MEDICAL CENTER LAKELAND LLC
Active
Parent organization
PALM MEDICAL CENTER LAKELAND LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PALM MEDICAL CENTER LAKELAND LLC
Authorized official
CARMEL N BOSWELL (CREDENTIALING MANAGER)
(813) 538-7880
Entity
Organization
Contact information
Practice address
5258 LINTON BLVD STE 301, DELRAY BEACH, FL 33484-6539
(561) 819-5447
(561) 819-5496
Mailing address
5258 LINTON BLVD STE 301, DELRAY BEACH, FL 33484-6539
(561) 819-5447
(561) 819-5496
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276547100
—
FL
Enumeration date
04/18/2022
Last updated
04/18/2022
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