| Palm Beach Vascular And Wound Care Pa | |
|
1004 S Old Dixie Hwy Ste 203 Jupiter FL 33458-7200 | |
| (561) 691-1904 | |
| Not Available |
| Full Name | Palm Beach Vascular And Wound Care Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1004 S Old Dixie Hwy Ste 203, Jupiter, Florida |
| Authorized Official Name and Position | Suresh B Kacham (MD) |
| Authorized Official Contact | 5616911904 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Palm Beach Vascular And Wound Care Pa 1004 S Old Dixie Hwy Ste 203 Jupiter FL 33458-7200 Ph: (561) 691-1904 | Palm Beach Vascular And Wound Care Pa 1004 S Old Dixie Hwy Ste 203 Jupiter FL 33458-7200 Ph: (561) 691-1904 |
| NPI Number | 1093266314 |
|---|---|
| Provider Enumeration Date | 10/21/2016 |
| Last Update Date | 02/15/2024 |
| Medicare PECOS PAC ID | 5395014237 |
|---|---|
| Medicare Enrollment ID | O20170707002257 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093266314 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME77546 (Florida) | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | ME77546 (Florida) | Primary |
| Provider Name | Suresh B Kacham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578692026 PECOS PAC ID: 5193735546 Enrollment ID: I20060428000396 |
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