Provider Demographics
NPI:1558514240
Name:PLANTATION POINTE SURGERY AND ENDOSCOPY, LLC
Entity Type:Organization
Organization Name:PLANTATION POINTE SURGERY AND ENDOSCOPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:V
Authorized Official - Last Name:LALLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-286-9762
Mailing Address - Street 1:1033 W MEETING ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-2205
Mailing Address - Country:US
Mailing Address - Phone:803-286-9762
Mailing Address - Fax:803-286-9765
Practice Address - Street 1:1033 W MEETING ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-2205
Practice Address - Country:US
Practice Address - Phone:803-286-9762
Practice Address - Fax:803-286-9765
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANCASTER SURGICAL ASSOCIATES, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17757174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty