# VITREO RETINAL CONSULTANTS OF THE PALM BEACHES PA

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

## Provider details

- **NPI number:** 1871550996
- **Authorized official:** MR. SALOMON EMILIO MELGEN MD (PRESIDENT OF CORPORATION)
- **Authorized official phone:** (561) 687-0007

## Contact information

- **Practice address:** 2521 METROCENTRE BLVD, WEST PALM BEACH, FL 33407
- **Practice address phone:** (561) 687-0007
- **Practice address fax:** (561) 688-0431
- **Mailing address:** 2521 METROCENTRE BLVD, WEST PALM BEACH, FL 33407
- **Mailing address phone:** (561) 687-0007
- **Mailing address fax:** (561) 688-0431

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/01/2006
- **Last updated:** 12/19/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 064710100 | — | FL |
| 01 | — | 56172 | BLUE CROSS BLUE SHIELD | FL |