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1217 S Military Trl Ste C West Palm Beach FL 33415-4600 | |
| (561) 342-5000 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | General Practice |
| Location | 1217 S Military Trl Ste C, West Palm Beach, Florida |
| Authorized Official Name and Position | Ricardo A Martinez (MANAGER) |
| Authorized Official Contact | 7864239423 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1217 S Military Trl Ste C West Palm Beach FL 33415-4600 Ph: (561) 342-5000 | 1217 S Military Trl Ste C West Palm Beach FL 33415-4600 Ph: (561) 342-5000 |
| NPI Number | 1114757044 |
|---|---|
| Provider Enumeration Date | 08/05/2024 |
| Last Update Date | 01/07/2025 |
| Medicare PECOS PAC ID | 0244771947 |
|---|---|
| Medicare Enrollment ID | O20241023004642 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114757044 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Yandro Leal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932690021 PECOS PAC ID: 0042611501 Enrollment ID: I20210622002652 |
| Provider Name | Yoalisbett Martinez Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477326411 PECOS PAC ID: 5092165704 Enrollment ID: I20231221000458 |
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