Provider Demographics
NPI:1235284134
Name:HEMATOLOGY ONCOLOGY ASSOCIATES OF THE PALM BEACHES
Entity Type:Organization
Organization Name:HEMATOLOGY ONCOLOGY ASSOCIATES OF THE PALM BEACHES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTENER
Authorized Official - Prefix:DR
Authorized Official - First Name:SURENDRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SIRPAL
Authorized Official - Suffix:
Authorized Official - Credentials:
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 1:4685 S CONGRESS AVE STE 200
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-4710
Practice Address - Country:US
Practice Address - Phone:561-965-1864
Practice Address - Fax:561-967-5005
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEMATOLOGY ONCOLOGY ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-24
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9170502363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT532992Medicare UPIN