Organization
PALM BEACH DERMATOLOGY INSTITUTE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAL BLAKE RIDGWAY M.D. (PRES)
(561) 964-7500
Entity
Organization
Contact information
Practice address
1760 N CONGRESS AVE, SUITE 200, BOYNTON BEACH, FL 33426-8214
(561) 733-0077
(561) 733-0020
Mailing address
1760 N CONGRESS AVE, SUITE 200, BOYNTON BEACH, FL 33426-8214
(561) 733-0077
(561) 733-0020
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
ME54995
FL
Other
Enumeration date
07/20/2009
Last updated
08/25/2009
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