Provider Demographics
NPI:1174542344
Name:DELRAY MEDICAL ASSOCIATES, INC
Entity type:Organization
Organization Name:DELRAY MEDICAL ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SABATES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-637-4125
Mailing Address - Street 1:6646 W ATLANTIC AVE
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-1616
Mailing Address - Country:US
Mailing Address - Phone:561-637-4125
Mailing Address - Fax:561-637-4128
Practice Address - Street 1:6646 W ATLANTIC AVE
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-1616
Practice Address - Country:US
Practice Address - Phone:561-637-4125
Practice Address - Fax:561-637-4128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0058466207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11752Medicare ID - Type UnspecifiedMEDICARE
FL11752Medicare PIN