# PALM BEACH OBSTETRICS & GYNECOLOGY, PA

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

## Provider details

- **NPI number:** 1922279389
- **Authorized official:** MRS. VIVIAN VITERI (ADMINISTRATOR)
- **Authorized official phone:** (561) 434-0111

## Contact information

- **Practice address:** 4671 S CONGRESS AVE, SUITE 100B, LAKE WORTH, FL 33461-4783
- **Practice address phone:** (561) 434-0111
- **Practice address fax:** (561) 296-3533
- **Mailing address:** 4671 S CONGRESS AVE, SUITE 100B, LAKE WORTH, FL 33461-4783
- **Mailing address phone:** (561) 434-0111
- **Mailing address fax:** (561) 296-3533

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/13/2008
- **Last updated:** 04/03/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 002004200 | — | FL |
| 05 | — | 004197300 | — | FL |
| 05 | — | 256189100 | — | FL |
| 05 | — | 272505300 | — | FL |
| 05 | — | 272506100 | — | FL |
| 05 | — | 371772100 | — | FL |