Provider Demographics
NPI:1427270982
Name:PALM BEACH PRIMARY CARE ASSOCIATES INC
Entity type:Organization
Organization Name:PALM BEACH PRIMARY CARE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHEKHAR
Authorized Official - Middle Name:V
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-795-9087
Mailing Address - Street 1:PO BOX 1602
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-1602
Mailing Address - Country:US
Mailing Address - Phone:561-795-9087
Mailing Address - Fax:561-753-8730
Practice Address - Street 1:3347 STATE ROAD 7
Practice Address - Street 2:STE 200
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33449-8095
Practice Address - Country:US
Practice Address - Phone:561-795-9087
Practice Address - Fax:561-795-4036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME-0047072174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL03716ZOtherMEDICARE ID
FL049760600Medicaid
FL049760600Medicaid
FLK1552Medicare PIN