Organization · NPI-2
10th Ave Medical Associates, LLC
Psychiatry & Neurology, Addiction Psychiatry · Lake Worth, FL
NPI number1497066914
StatusActive
Last updated in NPPESOct 15, 2012
Details
- NPI
- 1497066914
- Entity type
- Organization (NPI-2)
- Legal business name
- 10th Ave Medical Associates, LLC
- Organization subpart
- No
- Enumeration date
- Jun 30, 2010
- Last updated
- Oct 15, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0802X | Psychiatry & Neurology, Addiction Psychiatry | ME83014 | FL | Yes |
Practice location
3185 Boutwell RdLake Worth, FL 33461-2610
Phone 561-533-0074
Mailing address
Po Box 7240Jupiter, FL 33468-7240
Phone 561-748-2889 · Fax 561-748-1523
Authorized official
Karen Barlow
President Jupiter Prof Development
5617482889
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