Provider Demographics
NPI:1578676870
Name:PLASTIC SURGERY INSTITUTE OF THE PALM BEACHES INC
Entity Type:Organization
Organization Name:PLASTIC SURGERY INSTITUTE OF THE PALM BEACHES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:BAFITIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-795-3787
Mailing Address - Street 1:4601 MILITARY TRAIL
Mailing Address - Street 2:SUITE 208
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458
Mailing Address - Country:US
Mailing Address - Phone:561-795-3787
Mailing Address - Fax:561-798-0003
Practice Address - Street 1:4601 MILITARY TRL
Practice Address - Street 2:SUITE 208
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-4834
Practice Address - Country:US
Practice Address - Phone:561-795-3787
Practice Address - Fax:561-798-0003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0005647174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3435WELLOtherNEIGHBORHOOD HEALTH
FL06388OtherSTAYWELL & WELLCARE
FL80174OtherBLUE CROSS BLUE SHIELD
FL06388OtherSTAYWELL & WELLCARE
FL3435WELLOtherNEIGHBORHOOD HEALTH
FLA83065Medicare UPIN