Provider Demographics
NPI:1023005600
Name:PSHS BETA PARTNERS LTD
Entity Type:Organization
Organization Name:PSHS BETA PARTNERS LTD
Other - Org Name:THE GABLES SURGICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/COO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-569-6500
Mailing Address - Street 1:401 SW 42 LEJEUNE ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33134
Mailing Address - Country:US
Mailing Address - Phone:305-447-0882
Mailing Address - Fax:305-447-0213
Practice Address - Street 1:401 S. LEJEUNE RD.
Practice Address - Street 2:SUITE 201
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33134-1938
Practice Address - Country:US
Practice Address - Phone:305-447-0882
Practice Address - Fax:305-447-0213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1090261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL68BOtherBLUE CROSS BLUE SHIELD
FL68BOtherBLUE CROSS BLUE SHIELD