Provider Demographics
NPI:1619992120
Name:SOUTH PALM ORTHOPEDICS P A
Entity Type:Organization
Organization Name:SOUTH PALM ORTHOPEDICS P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:BUCHALTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-496-6622
Mailing Address - Street 1:4800 LINTON BLVD
Mailing Address - Street 2:BUILDING A, SUITE 201
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-6584
Mailing Address - Country:US
Mailing Address - Phone:561-496-6622
Mailing Address - Fax:561-496-3835
Practice Address - Street 1:4800 LINTON BLVD
Practice Address - Street 2:BUILDING A, SUITE 201
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6584
Practice Address - Country:US
Practice Address - Phone:561-496-6622
Practice Address - Fax:561-496-3835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4099470001Medicare NSC
FL33330Medicare PIN