Provider Demographics
NPI:1326180894
Name:PALM BEACH PLASTIC SURGERY CENTER LLC
Entity Type:Organization
Organization Name:PALM BEACH PLASTIC SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:KAPP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-833-4022
Mailing Address - Street 1:1500 N DIXIE HWY
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2712
Mailing Address - Country:US
Mailing Address - Phone:561-833-4022
Mailing Address - Fax:561-833-4180
Practice Address - Street 1:1500 N DIXIE HWY
Practice Address - Street 2:SUITE 304
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2712
Practice Address - Country:US
Practice Address - Phone:561-833-4022
Practice Address - Fax:561-833-4180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical