Provider Demographics
NPI:1154530970
Name:FLAMINGO PARK MEDICAL CENTER OF WEST PALM BEACH,INC
Entity type:Organization
Organization Name:FLAMINGO PARK MEDICAL CENTER OF WEST PALM BEACH,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGE
Authorized Official - Middle Name:ERNEST
Authorized Official - Last Name:CAYEMITTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-835-9595
Mailing Address - Street 1:625 BELVEDERE RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33405-1230
Mailing Address - Country:US
Mailing Address - Phone:561-835-9595
Mailing Address - Fax:561-835-0072
Practice Address - Street 1:625 BELVEDERE RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405-1230
Practice Address - Country:US
Practice Address - Phone:561-835-9595
Practice Address - Fax:561-835-0072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0060492261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2699Medicare ID - Type UnspecifiedPROVIDER I.D.