| Intermed Services, Pa | |
|
1115 45th St Suite 1a West Palm Beach FL 33407-2376 | |
| (561) 845-2081 | |
| (561) 845-2953 |
| Full Name | Intermed Services, Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 1115 45th St, West Palm Beach, Florida |
| Authorized Official Name and Position | Shaheed Kalloo (CEO) |
| Authorized Official Contact | 5618452081 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intermed Services, Pa Po Box 10694 Riviera Beach FL 33419-0694 Ph: (561) 845-2081 | Intermed Services, Pa 1115 45th St Suite 1a West Palm Beach FL 33407-2376 Ph: (561) 845-2081 |
| NPI Number | 1013209980 |
|---|---|
| Provider Enumeration Date | 05/10/2011 |
| Last Update Date | 05/10/2011 |
| Medicare PECOS PAC ID | 2264689116 |
|---|---|
| Medicare Enrollment ID | O20120828000335 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013209980 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME0075961 (Florida) | Primary |
| Provider Name | Shaheed G Kalloo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619024957 PECOS PAC ID: 1052568904 Enrollment ID: I20120910000231 |
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