Provider Demographics
NPI:1043803877
Name:PALM BEACH INTERNATIONAL SURGERY CENTER LLC
Entity Type:Organization
Organization Name:PALM BEACH INTERNATIONAL SURGERY CENTER LLC
Other - Org Name:PALM BEACH INTERNATIONAL SURGERY CENTER AT THE PALEY INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:COLLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMAISTRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-250-3640
Mailing Address - Street 1:14201 DALLAS PKWY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-2916
Mailing Address - Country:US
Mailing Address - Phone:469-872-4706
Mailing Address - Fax:972-767-3547
Practice Address - Street 1:5325 GREENWOOD AVE STE 301
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2452
Practice Address - Country:US
Practice Address - Phone:561-273-4333
Practice Address - Fax:561-273-4850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-12
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical