Pure Age Management, LLC
Internal Medicine in Boynton Beach, FL. Organization (NPI-2).
NPI number1245656263
StatusActive
Last updated in NPPESMar 14, 2014
Details
- NPI
- 1245656263
- Entity type
- Organization (NPI-2)
- Legal business name
- Pure Age Management, LLC
- Organization subpart
- No
- Enumeration date
- Mar 14, 2014
- Last updated
- Mar 14, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | OS9731 | FL | Yes |
Practice location
1015 Gateway BlvdSuite 401
Boynton Beach, FL 33426-8347
Phone 561-847-4654
Mailing address
1015 Gateway BlvdSuite 401
Boynton Beach, FL 33426-8347
Phone 561-847-4654
Authorized official
Michael W Gempel
Co-Owner
5618474654
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