Organization Name: | PALM BEACH ENDOSCOPY AND SURGERY CENTER LLC |
NPI Number: | 1073812376 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID W. HOLST (PRESIDENT, BOARD OF MANAGERS) |
Mailing Address: | 1157 S State Road 7 Wellington |
State: | FL US |
Postal Code: | 334146101 |
Phone Number: | 5617953330 |
Fax Number: | 6153456905 |
NPI Enumeration Date: | 03/25/2011 |
NPI Last Update Date: | 06/03/2011 |
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: |