# PALM BEACH DERMATOLOGY INSTITUTE, INC.

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

## Provider details

- **NPI number:** 1780814103
- **Authorized official:** DR. HAL BLAKE RIDGWAY M.D. (PRES)
- **Authorized official phone:** (561) 964-7500

## Contact information

- **Practice address:** 1760 N CONGRESS AVE, SUITE 200, BOYNTON BEACH, FL 33426-8214
- **Practice address phone:** (561) 733-0077
- **Practice address fax:** (561) 733-0020
- **Mailing address:** 1760 N CONGRESS AVE, SUITE 200, BOYNTON BEACH, FL 33426-8214
- **Mailing address phone:** (561) 733-0077
- **Mailing address fax:** (561) 733-0020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | ME54995 | FL | Yes |

## Other

- **Enumeration date:** 07/20/2009
- **Last updated:** 08/25/2009