| Organization Name: | PALM BEACH GARDENS REGIONAL SURGERY CENTER LLC |
| NPI Number: | 1003205196 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ISAAC VERBUKH (OWNER PRESIDENT) |
| Mailing Address: | 11030 Rca Center Dr 3001 Palm Beach Gardens |
| State: | FL US |
| Postal Code: | 334104276 |
| Phone Number: | 5613923341 |
| Fax Number: | |
| NPI Enumeration Date: | 01/13/2015 |
| NPI Last Update Date: | 01/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |