Provider Demographics
NPI:1447895925
Name:COMMUNITY HEALTH MEDICAL CENTER LLC
Entity type:Organization
Organization Name:COMMUNITY HEALTH MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PAVAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-305-2562
Mailing Address - Street 1:3951 N HAVERHILL RD STE 117
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-8349
Mailing Address - Country:US
Mailing Address - Phone:561-249-7879
Mailing Address - Fax:561-328-9082
Practice Address - Street 1:3951 N HAVERHILL RD STE 117
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-8349
Practice Address - Country:US
Practice Address - Phone:561-249-7879
Practice Address - Fax:561-328-9082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare