Provider Demographics
NPI:1861574030
Name:PEDIATRIC PARTNERS OF PALM BEACH COUNTY
Entity type:Organization
Organization Name:PEDIATRIC PARTNERS OF PALM BEACH COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TOMMY
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:SCHECHTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-745-4222
Mailing Address - Street 1:3401 PGA BLVD
Mailing Address - Street 2:SUITE #300
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2823
Mailing Address - Country:US
Mailing Address - Phone:561-745-4222
Mailing Address - Fax:561-627-0040
Practice Address - Street 1:3401 PGA BLVD
Practice Address - Street 2:SUITE #300
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2823
Practice Address - Country:US
Practice Address - Phone:561-745-4222
Practice Address - Fax:561-627-0040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254459800Medicaid