Organization Name: | INTERMED SERVICES, PA |
NPI Number: | 1013209980 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHAHEED KALLOO (CEO) |
Mailing Address: | 1115 45th St Suite 1a West Palm Beach |
State: | FL US |
Postal Code: | 334072376 |
Phone Number: | 5618452081 |
Fax Number: | 5618452953 |
NPI Enumeration Date: | 05/10/2011 |
NPI Last Update Date: | 05/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | ME0075961 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |