Provider Demographics
NPI:1548280027
Name:ISLAND MEDICAL CARE LLC
Entity type:Organization
Organization Name:ISLAND MEDICAL CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EARL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAMPAZZI
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:561-440-8879
Mailing Address - Street 1:440 ROYAL PALM WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-4179
Mailing Address - Country:US
Mailing Address - Phone:561-440-8879
Mailing Address - Fax:561-422-4033
Practice Address - Street 1:440 ROYAL PALM WAY STE 100
Practice Address - Street 2:
Practice Address - City:PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480-4179
Practice Address - Country:US
Practice Address - Phone:561-440-8879
Practice Address - Fax:561-422-4033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 692522083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAC413Medicare PIN