Provider Demographics
NPI:1154452035
Name:HEMATOLOGY ONCOLOGY ASSOCIATES OF THE PALM BEACHES
Entity Type:Organization
Organization Name:HEMATOLOGY ONCOLOGY ASSOCIATES OF THE PALM BEACHES
Other - Org Name:HEMATOLOGY ONCOLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SURENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIRPAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-965-1864
Mailing Address - Street 1:4685 S CONGRESS AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-4710
Mailing Address - Country:US
Mailing Address - Phone:561-965-1864
Mailing Address - Fax:561-967-5005
Practice Address - Street 1:2300 S CONGRESS AVE STE 103
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-7400
Practice Address - Country:US
Practice Address - Phone:561-732-2440
Practice Address - Fax:561-732-4109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057839800Medicaid