Provider Demographics
NPI:1093932287
Name:VERO BEACH OUTPATIENT SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:VERO BEACH OUTPATIENT SURGICAL CENTER LLC
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENWALD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:772-226-9950
Mailing Address - Street 1:1255 37TH ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6550
Mailing Address - Country:US
Mailing Address - Phone:772-226-9950
Mailing Address - Fax:
Practice Address - Street 1:1255 37TH ST
Practice Address - Street 2:SUITE E
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6550
Practice Address - Country:US
Practice Address - Phone:772-226-9950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1276261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical