| Idl Medical Pa | |
|
8767 Boynton Beach Blvd Boynton Beach FL 33472-4479 | |
| (561) 734-5484 | |
| (561) 734-5485 |
| Full Name | Idl Medical Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 8767 Boynton Beach Blvd, Boynton Beach, Florida |
| Authorized Official Name and Position | Diana Gorokhovksy (PRESIDENT) |
| Authorized Official Contact | 3057255529 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Idl Medical Pa 8767 Boynton Beach Blvd Boynton Beach FL 33472-4479 Ph: (561) 734-5484 | Idl Medical Pa 8767 Boynton Beach Blvd Boynton Beach FL 33472-4479 Ph: (561) 734-5484 |
| NPI Number | 1487839635 |
|---|---|
| Provider Enumeration Date | 01/07/2008 |
| Last Update Date | 06/14/2023 |
| Medicare PECOS PAC ID | 6204902992 |
|---|---|
| Medicare Enrollment ID | O20080903000534 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487839635 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Diana Gorokhovsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982728705 PECOS PAC ID: 1052487741 Enrollment ID: I20080903000514 |
| Provider Name | Kim S Geiringer |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1548752694 PECOS PAC ID: 4082089610 Enrollment ID: I20230412001016 |
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