Tackey, Frederick S
Tackey, Frederick S is an individual health care provider with primary practice located at 2300 South Congress Avenue #101 , Boynton Beach FL 33426. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Tackey, Frederick S can be contacted via phone (561) 374-8919.Contact Information
Primary practice address
2300 South Congress Avenue #101
Boynton Beach FL 33426
Phone: (561) 374-8919
Fax: (561) 374-8911
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 0068055 | Florida |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 0068055 | Florida |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 0068055 | Florida |
Profile Details
| NPI number | 1689743445 |
|---|---|
| LBN Legal business name | Tackey, Frederick S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 7th, 2006 |
| Last updated | Sep 1st, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689743445 | NPPES |
| Florida | MEDICAID | 377890800 |
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