Provider Demographics
NPI:1467872242
Name:PALM BEACH ORTHOPAEDIC INSTITUTE, PA
Entity Type:Organization
Organization Name:PALM BEACH ORTHOPAEDIC INSTITUTE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PRIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDRADAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-694-7776
Mailing Address - Street 1:4215 BURNS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4625
Mailing Address - Country:US
Mailing Address - Phone:561-727-1122
Mailing Address - Fax:
Practice Address - Street 1:7701 SOUTHERN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-3803
Practice Address - Country:US
Practice Address - Phone:561-694-7776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PALM BEACH ORTHOPAEDIC INSTITUTE, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-21
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77605332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site