Deactivated NPI 1689776213 Deactivated / Inactive NPI Male Practitioner

Dr. Hugo E Polanco , MD

Internal Medicine • Delray Beach, FL

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Hugo Polanco has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 03, 2006

NPI Deactivation Date June 21, 2022

Total Practice Duration ~16 Years of Practice (2006 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Hugo Polanco, MD was a registered Internal Medicine practicing in Delray Beach, FL. Throughout an active medical career spanning 16 years, Dr. Polanco provided care at the practice location at 16244 S MILITARY TRL until profile deactivation on 2022-06-21.

Historical Medicare Part B clinical services included established patient outpatient office visit, chronic care management services, first, outpatient office visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

16244 S Military Trl
Suite 470

Delray Beach, FL 334846534

Telephone 5618655151

Associated Practice Facility / Clinic

🏢 Sng Labs-Sng Prosthetic Eye Institute, Inc. Facility NPI 1558325480

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Delray Beach, FL

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 27.8 Yrs

State Avg: 26.5 Yrs

Regional Practice Density

101 Specialists

Practicing in Delray Beach, FL (10650 Statewide)

Telehealth Adoption Rate

30.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

41.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2022)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	452	213	$152.00	$94.32
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	180	119	$80.00	$66.07
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	135	106	$45.00	$23.79
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	125	92	$225.00	$133.00
99443 Telephone medical discussion with physician, 21-30 minutes	122	91	$190.00	$132.94
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	64	64	$232.00	$133.65
G0442 Annual alcohol misuse screening, 5 to 15 minutes	61	61	$37.00	$19.23
G0444 Annual depression screening, 5 to 15 minutes	61	61	$37.00	$18.90
36415 Insertion of needle into vein for collection of blood sample	43	41	$10.00	$2.99
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	42	32	$92.00	$59.38
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	40	40	$54.00	$27.68
99496 Transitional care management services for problem of high complexity	23	18	$484.00	$288.58
99442 Telephone medical discussion with physician, 11-20 minutes	17	16	$150.00	$94.34
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$345.00	$176.40
99497 Advance care planning, first 30 minutes	12	12	$180.00	$88.13

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,007	278	$152.00	$95.34
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	609	169	$80.00	$42.39
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	266	164	$225.00	$135.46
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	262	151	$45.00	$23.35
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	187	187	$232.00	$136.58
G0442 Annual alcohol misuse screening, 5 to 15 minutes	180	180	$37.00	$19.15
G0444 Annual depression screening, 5 to 15 minutes	178	178	$37.00	$19.15
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	177	114	$92.00	$58.41
99443 Telephone medical discussion with physician, 21-30 minutes	129	101	$190.00	$136.11
36415 Insertion of needle into vein for collection of blood sample	124	92	$10.00	$3.00
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	115	115	$54.00	$28.08
99442 Telephone medical discussion with physician, 11-20 minutes	90	64	$150.00	$96.16
99439 Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month	66	38	$80.00	$38.90
99497 Advance care planning, first 30 minutes	54	52	$180.00	$88.87
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	51	14	$42.00	$14.61
99496 Transitional care management services for problem of high complexity	44	35	$484.00	$288.63
93000 Routine ekg using at least 12 leads including interpretation and report	39	38	$40.00	$15.61
81003 Automated urinalysis test	28	25	$25.00	$2.25
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	21	18	$115.00	$54.92
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	19	19	$345.00	$176.90
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	16	15	$45.00	$29.94
G0008 Administration of influenza virus vaccine	16	15	$50.00	$17.41
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$228.00	$118.31
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	11	11	$435.00	$233.76

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,078	315	$152.00	$79.37
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	775	194	$80.00	$44.21
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	586	261	$225.00	$115.01
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	268	145	$92.00	$48.23
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	214	143	$45.00	$24.09
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	162	162	$232.00	$121.52
G0442 Annual alcohol misuse screening, 5 to 15 minutes	153	153	$37.00	$19.04
G0444 Annual depression screening, 5 to 15 minutes	147	147	$37.00	$19.05
99443 Telephone medical discussion with physician, 21-30 minutes	138	79	$177.48	$111.67
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	123	123	$54.00	$28.03
36415 Insertion of needle into vein for collection of blood sample	122	96	$10.00	$2.99
99497 Advance care planning, first 30 minutes	116	112	$180.00	$91.06
99442 Telephone medical discussion with physician, 11-20 minutes	69	54	$143.77	$78.10
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	66	22	$218.00	$109.86
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	65	15	$42.00	$14.91
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic	63	48	$30.00	$15.44
G2058 Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure). (do not report g2058 fo	48	39	$80.00	$39.22
99358 Prolonged patient service without direct patient contact first hour	45	43	$235.00	$118.33
93000 Routine ekg using at least 12 leads including interpretation and report	43	40	$40.00	$18.18
99496 Transitional care management services for problem of high complexity	39	33	$484.00	$252.74
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	37	29	$115.00	$56.33
G0009 Administration of pneumococcal vaccine	32	30	$60.00	$17.30
G0008 Administration of influenza virus vaccine	30	29	$50.00	$17.34
90756 Vaccine for influenza for injection into muscle	29	29	$45.00	$27.70
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	28	28	$345.00	$175.07
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	20	18	$128.00	$118.60
81003 Automated urinalysis test	15	15	$25.00	$2.24
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	13	12	$425.00	$214.45
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	13	13	$435.00	$221.42
90670 Pneumococcal vaccine for injection into muscle	12	12	$350.00	$228.49
99239 Hospital discharge day management, more than 30 minutes	12	11	$225.00	$112.50

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	1,037	231	$80.00	$43.36
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,019	314	$225.00	$113.10
99213 Established patient office or other outpatient visit, typically 15 minutes	589	243	$151.82	$77.42
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	333	112	$218.00	$109.49
36415 Insertion of needle into vein for collection of blood sample	317	187	$10.00	$2.94
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	238	137	$45.00	$23.46
99497 Advance care planning, first 30 minutes	196	192	$180.00	$88.81
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	195	195	$232.00	$121.17
G0442 Annual alcohol misuse screening, 5 to 15 minutes	192	192	$37.00	$18.71
G0444 Annual depression screening, 5 to 15 minutes	164	164	$37.00	$18.71
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	124	124	$54.00	$27.49
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	116	100	$425.00	$212.05
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	109	18	$42.00	$17.28
81003 Automated urinalysis test	85	77	$25.00	$2.44
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	78	42	$280.00	$142.22
99239 Hospital discharge day management, more than 30 minutes	75	67	$225.00	$112.24
85610 Blood test, clotting time	58	12	$10.00	$4.28
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	56	56	$345.00	$170.04
99496 Transitional care management services for problem of high complexity	55	47	$484.00	$233.94
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	49	30	$92.00	$47.04
93000 Routine ekg using at least 12 leads including interpretation and report	47	46	$40.00	$17.93
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	47	20	$152.00	$76.66
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	44	41	$115.00	$55.59
99306 Initial nursing facility visit, typically 45 minutes per day	42	39	$354.00	$174.73
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	31	29	$290.00	$144.98
99358 Prolonged patient service without direct patient contact first hour	30	29	$235.00	$111.94
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	28	24	$302.00	$152.24
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	28	28	$435.00	$211.96
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	27	22	$85.00	$42.78
99335 Established patient assisted living visit, typically 25 minutes	26	16	$200.00	$99.72
G0008 Administration of influenza virus vaccine	23	23	$50.00	$17.00
99336 Established patient assisted living visit, typically 40 minutes	23	13	$200.00	$142.47
90653 Vaccine for influenza for injection into muscle	23	23	$42.17	$41.33
99220 Hospital observation care, typically 70 minutes	21	21	$390.00	$195.45
99406 Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes	19	11	$30.00	$15.70
G0009 Administration of pneumococcal vaccine	19	19	$60.00	$17.00
96116 Exam of neurobehavioral status, first hour	18	17	$200.00	$99.84
99217 Hospital observation care on day of discharge	14	14	$155.00	$76.80
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	13	13	$120.00	$111.44
99238 Hospital discharge day management, 30 minutes or less	13	13	$153.00	$73.06
99316 Nursing facility discharge management, more than 30 minutes	12	12	$222.00	$111.07
99495 Transitional care management services for problem of at least moderate complexity	11	11	$340.00	$170.54
99326 New patient assisted living visit, typically 45 minutes	11	11	$300.00	$146.02
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	11	11	$350.00	$169.91
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	11	11	$195.00	$179.05

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	787	214	$58.53	$43.53
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	667	243	$151.35	$111.12
36415 Insertion of needle into vein for collection of blood sample	331	195	$10.00	$2.94
99213 Established patient office or other outpatient visit, typically 15 minutes	312	179	$149.64	$75.43
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	169	169	$244.85	$117.90
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	133	65	$144.30	$108.23
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	112	112	$203.88	$171.98
G0444 Annual depression screening, 5 to 15 minutes	111	111	$49.77	$18.40
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	108	45	$94.89	$76.03
G0442 Annual alcohol misuse screening, 5 to 15 minutes	90	90	$36.38	$13.77
99306 Initial nursing facility visit, typically 45 minutes per day	71	61	$212.96	$173.26
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	71	44	$174.93	$141.58
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	68	60	$244.71	$55.64
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	61	58	$537.91	$150.08
90656 Vaccine for influenza for administration into muscle, 0.5 ml dosage	54	54	$102.78	$19.37
93000 Routine ekg using at least 12 leads including interpretation and report	54	52	$25.56	$17.71
G0008 Administration of influenza virus vaccine	53	53	$35.28	$20.91
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	49	49	$250.00	$216.80
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	40	39	$293.75	$212.24
99496 Transitional care management services for problem of high complexity	39	33	$382.76	$239.79
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	37	28	$217.46	$95.25
G0009 Administration of pneumococcal vaccine	33	33	$49.39	$20.28
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	32	25	$72.19	$22.08
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	31	31	$189.84	$143.54
99239 Hospital discharge day management, more than 30 minutes	31	26	$160.48	$111.87
90670 Pneumococcal vaccine for injection into muscle	26	26	$242.88	$191.20
99220 Hospital observation care, typically 70 minutes	22	21	$547.04	$194.49
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	21	20	$91.43	$42.94
99217 Hospital observation care on day of discharge	15	15	$245.49	$76.16
99497 Advance care planning, first 30 minutes	15	15	$150.00	$87.82
99335 Established patient assisted living visit, typically 25 minutes	13	12	$150.00	$98.52
99358 Prolonged patient service without direct patient contact first hour	12	11	$235.00	$116.56
99495 Transitional care management services for problem of at least moderate complexity	12	12	$175.00	$169.05

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	424	144	$85.00	$70.03
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	352	149	$150.00	$103.88
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	220	57	$185.00	$66.97
36415 Insertion of needle into vein for collection of blood sample	208	119	$10.00	$2.94
99213 Established patient office or other outpatient visit, typically 15 minutes	152	95	$125.00	$70.70
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	122	70	$120.00	$101.51
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	122	34	$171.16	$43.23
99334 Established patient custodial care facility, group care, or assisted living visit, typically 15 minutes	112	39	$238.98	$58.76
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	109	95	$175.00	$133.86
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	102	66	$55.00	$40.68
99306 Initial nursing facility visit, typically 45 minutes per day	78	71	$200.00	$161.37
99238 Hospital discharge day management, 30 minutes or less	73	62	$286.16	$70.19
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	64	57	$287.95	$52.01
99335 Established patient assisted living visit, typically 25 minutes	47	26	$100.00	$92.34
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	46	30	$150.00	$131.87
99220 Hospital observation care, typically 70 minutes	43	41	$635.66	$180.70
99316 Nursing facility discharge management, more than 30 minutes	37	36	$327.09	$102.69
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	37	37	$245.00	$111.10
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	27	20	$220.00	$88.38
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	27	26	$250.00	$197.62
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	25	25	$200.00	$160.73
90656 Vaccine for influenza for administration into muscle, 0.5 ml dosage	23	23	$50.00	$18.80
99239 Hospital discharge day management, more than 30 minutes	22	22	$125.00	$104.14
93000 Routine ekg using at least 12 leads including interpretation and report	20	19	$25.00	$16.61
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	18	11	$100.00	$39.87
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	16	15	$160.00	$126.14
99217 Hospital observation care on day of discharge	15	14	$290.73	$70.77
99496 Transitional care management services for problem of high complexity	15	13	$744.36	$222.41
G0444 Annual depression screening, 5 to 15 minutes	13	13	$50.00	$17.18
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	12	12	$537.91	$139.79

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License FL ME95737

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners

Travis Thornton , FNP-BC

Nurse Practitioner - Family

NPI 1154874923

Family Nurse Practitioner (Board Certified)

Michelle Archambault , MSN, APRN, AGPCNP-BC

Nurse Practitioner

NPI 1518566090

Master of Science in Nursing, Advanced Practice Registered Nurse, AGPCNPBC

Dr. Ernesto Porras Polo , MD

Internal Medicine

NPI 1952332652

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

⚠️

NPI Profile Deactivated June 21, 2022

Record deactivated on June 21, 2022

✅

NPI Profile Active September 02, 2014

NPI status registered as active in NPPES database

📍

Updated Practice Location September 02, 2014

Registered at 16244 S MILITARY TRL, SUITE 470, DELRAY BEACH, FL 334846534 (Tel: 5618655151)

📍

Updated Business Mailing Address September 02, 2014

Registered at PO BOX 6972, DELRAY BEACH, FL 334826972 (Tel: 5618655151)

👤

Provider Name / Credentials Updated September 02, 2014

Recorded as HUGO POLANCO, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 02, 2014

Internal Medicine (License #ME95737 in FL)

🟢

Initial NPI Registration & Enumeration September 03, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1689776213

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: September 03, 2006

Last Update: September 02, 2014

Deactivation Date: June 21, 2022

Update or Correct Profile

Mailing Address

Po Box 6972

Delray Beach, FL 334826972

Phone: 5618655151

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.