Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Peninsula Diagnostics PA

Organization Neurology Physician · NPI 1619207628

Peninsula Diagnostics PA provides Neurology Physician services in Boca Raton, Florida. Licensed in Florida. Registered with an NPI since 2010.

Licensed in
FL
In the registry since
2010
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1355 W Palmetto Park Rd #282
Boca Raton, FL 33486-3330 Not confirmed with CMS for 16 years — call before visiting
Phone: (888) 395-4007
Fax: (888) 395-3941
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X · Licence ME30779 (FL)

Record details

NPI number1619207628
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Russell Packard — Owner · (888) 395-4007
NPI enumeratedJanuary 14, 2010
Last updated in NPPESJanuary 14, 2010
Mailing address1355 W Palmetto Park Rd, 282, Boca Raton, FL 33486-3330

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