Organization Name: | PENTZKE MEDICAL CENTER INC |
NPI Number: | 1861413957 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ISIDRO GUILLERMO PENTZKE (OWNER) |
Mailing Address: | 6309 S Dixie Hwy West Palm Beach |
State: | FL US |
Postal Code: | 334054328 |
Phone Number: | 5615850640 |
Fax Number: | 5615850659 |
NPI Enumeration Date: | 07/22/2006 |
NPI Last Update Date: | 02/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME67383 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |