Organization
COLUMBIA PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY DUNCAN (VP)
(561) 881-2640
Entity
Organization
Contact information
Practice address
4631 N CONGRESS AVE, SUITE 202, WEST PALM BEACH, FL 33407-3209
(561) 881-2640
(561) 863-2304
Mailing address
4631 N CONGRESS AVE, SUITE 202, WEST PALM BEACH, FL 33407-3209
(561) 881-2640
(561) 863-2304
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF4508
RAILROAD MEDICARE
FL
Enumeration date
02/22/2007
Last updated
09/27/2007
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