Organization
MLEAC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY LYNN ENGROFF PT, PA-C (PRESIDENT)
(561) 346-9162
Entity
Organization
Contact information
Practice address
2580 METROCENTRE BLVD, SUITE 1, WEST PALM BEACH, FL 33407-3100
(561) 684-2022
(561) 455-2696
Mailing address
4774 S CLASSICAL BLVD, DELRAY BEACH, FL 33445-1225
(561) 346-9162
(561) 455-2696
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7384
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y5555
BCBS
FL
Enumeration date
10/19/2010
Last updated
10/19/2010
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