Provider Demographics
NPI:1457326761
Name:CENTER FOR BONE & JOINT SURGERY OF THE PALM BEACHES, P.A.
Entity Type:Organization
Organization Name:CENTER FOR BONE & JOINT SURGERY OF THE PALM BEACHES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTIJO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-798-6600
Mailing Address - Street 1:10131 FOREST HILL BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6109
Mailing Address - Country:US
Mailing Address - Phone:561-803-8616
Mailing Address - Fax:561-615-1956
Practice Address - Street 1:10131 W FOREST HILL BLVD STE 230
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6109
Practice Address - Country:US
Practice Address - Phone:561-803-8616
Practice Address - Fax:561-615-1958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-21
Last Update Date:2023-08-14
Deactivation Date:2018-07-25
Deactivation Code:
Reactivation Date:2018-08-17
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL33375Medicare ID - Type UnspecifiedGROUP NUMBER
FL0880870001Medicare NSC