Provider Demographics
NPI:1396211264
Name:PALM BEACH SURGICAL SUITES LLC
Entity Type:Organization
Organization Name:PALM BEACH SURGICAL SUITES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:COLLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMAISTRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-213-0732
Mailing Address - Street 1:4215 BURNS ROAD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4625
Mailing Address - Country:US
Mailing Address - Phone:561-508-2736
Mailing Address - Fax:561-508-2802
Practice Address - Street 1:4215 BURNS RD STE 150
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4625
Practice Address - Country:US
Practice Address - Phone:772-260-4018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-18
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical