Provider Demographics
NPI:1285655175
Name:INTERNAL MEDICINE ASSOCIATES OF THE PALM BEACHES PA
Entity type:Organization
Organization Name:INTERNAL MEDICINE ASSOCIATES OF THE PALM BEACHES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-366-8408
Mailing Address - Street 1:P.O. BOX 8296
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-0296
Mailing Address - Country:US
Mailing Address - Phone:561-366-8408
Mailing Address - Fax:561-366-8405
Practice Address - Street 1:1411 NO. FLAGLER DRIVE
Practice Address - Street 2:SUITE 4300
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3422
Practice Address - Country:US
Practice Address - Phone:561-366-8408
Practice Address - Fax:561-366-8405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X
FLME0065507207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL38486OtherBLUE CROSS FLORIDA
DB0979OtherRAILROAD MEDICARE
DB0979OtherRAILROAD MEDICARE
FL25835UMedicare UPIN