Provider Demographics
NPI:1144241308
Name:BSASPB PA
Entity Type:Organization
Organization Name:BSASPB PA
Other - Org Name:SURGICAL ASSOCIATES OF PALM BEACH COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:N
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-395-2626
Mailing Address - Street 1:670 GLADES ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431
Mailing Address - Country:US
Mailing Address - Phone:561-395-2626
Mailing Address - Fax:561-395-7026
Practice Address - Street 1:670 GLADES ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431
Practice Address - Country:US
Practice Address - Phone:561-395-2626
Practice Address - Fax:561-395-7026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK0025AMedicare PIN