Organization
PHYSICIANS MEDICAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BILL RUSSELL (CEO)
(954) 587-7771
Entity
Organization
Contact information
Practice address
4905 LANTANA RD, LAKE WORTH, FL 33463-6915
(954) 587-7771
(954) 208-5770
Mailing address
PO BOX 542318, GREENACRES, FL 33454-2318
(954) 587-7771
(954) 208-5770
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
Primary
ME57901
FL
1041C0700X
Clinical Social Worker
—
—
111N00000X
Chiropractor
—
—
133V00000X
Registered Dietitian
—
—
171100000X
Acupuncturist
—
—
2084P0800X
Psychiatry Physician
—
—
225700000X
Massage Therapist
—
—
Other
Enumeration date
05/27/2009
Last updated
09/22/2011
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