Provider Demographics
NPI:1033106612
Name:PSHS ALPHA PARTNERS LTD
Entity Type:Organization
Organization Name:PSHS ALPHA PARTNERS LTD
Other - Org Name:LAKE WORTH SURGICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER AND AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:B
Authorized Official - Last Name:BALDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-234-5954
Mailing Address - Street 1:7408 LAKE WORTH RD STE 900
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2502
Mailing Address - Country:US
Mailing Address - Phone:561-433-5700
Mailing Address - Fax:561-433-5901
Practice Address - Street 1:7408 LAKE WORTH RD STE 900
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2502
Practice Address - Country:US
Practice Address - Phone:561-433-5700
Practice Address - Fax:561-433-5901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1069261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0705721-00Medicaid
FL170233100OtherUS DEPT OF LABOR
FL67GOtherBLUE CROSS BLUE SHIELD