Organization
PALM BEACH PATHOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS A BOLTON MD (MEDICAL DIRECTOR)
(561) 659-0770
Entity
Organization
Contact information
Practice address
2013 PONCE DE LEON AVE, WEST PALM BEACH, FL 33407-6019
(561) 659-0770
(770) 776-5966
Mailing address
PO BOX 4117, WEST PALM BEACH, FL 33402-4117
(561) 659-0770
(770) 776-5966
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258264300
—
FL
01
—
L8267
BCBS
FL
Enumeration date
07/02/2007
Last updated
02/02/2010
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