| Neighborhood Family Doctor Of Palm Beach Llc | |
|
180 Jfk Dr Ste 250 Atlantis FL 33462-6642 | |
| (561) 969-1777 | |
| (561) 969-3621 |
| Full Name | Neighborhood Family Doctor Of Palm Beach Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 180 Jfk Dr Ste 250, Atlantis, Florida |
| Authorized Official Name and Position | Rodolfo Trejo (CEO OWNER) |
| Authorized Official Contact | 5619691777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neighborhood Family Doctor Of Palm Beach Llc 180 Jfk Dr Ste 250 Atlantis FL 33462-6642 Ph: (561) 969-1777 | Neighborhood Family Doctor Of Palm Beach Llc 180 Jfk Dr Ste 250 Atlantis FL 33462-6642 Ph: (561) 969-1777 |
| NPI Number | 1861661126 |
|---|---|
| Provider Enumeration Date | 02/20/2008 |
| Last Update Date | 03/11/2020 |
| Medicare PECOS PAC ID | 9739360413 |
|---|---|
| Medicare Enrollment ID | O20110301000505 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861661126 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME63826 (Florida) | Primary |
| Provider Name | Rodolfo Trejo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750335584 PECOS PAC ID: 7416967385 Enrollment ID: I20060424000152 |
| Provider Name | Adis D Santoyo Banasco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568240034 PECOS PAC ID: 4688021025 Enrollment ID: I20231107002619 |
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