Provider Demographics
NPI:1063580140
Name:PJL MANAGEMENT, INC
Entity type:Organization
Organization Name:PJL MANAGEMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:LORELLI
Authorized Official - Middle Name:SHARON
Authorized Official - Last Name:SITAHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-279-0991
Mailing Address - Street 1:200 CONGRESS PARK DR STE 210
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-4688
Mailing Address - Country:US
Mailing Address - Phone:561-279-0991
Mailing Address - Fax:561-279-0539
Practice Address - Street 1:200 CONGRESS PARK DR STE 210
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4688
Practice Address - Country:US
Practice Address - Phone:561-279-0991
Practice Address - Fax:561-279-0539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL267866700Medicaid