Provider Demographics
NPI:1194744052
Name:ROYAL PALM INTERNISTS PA
Entity type:Organization
Organization Name:ROYAL PALM INTERNISTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:904-268-0787
Mailing Address - Street 1:15340 JOG RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-2170
Mailing Address - Country:US
Mailing Address - Phone:561-819-6700
Mailing Address - Fax:
Practice Address - Street 1:15340 JOG RD
Practice Address - Street 2:SUITE 202
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-2170
Practice Address - Country:US
Practice Address - Phone:561-819-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDG0301OtherRAILROAD MEDICARE
FL7171856OtherAETNA
FL98960OtherBLUE CROSS BLUE SHIELD
FLAA271Medicare PIN