Provider Demographics
NPI:1710289780
Name:WESTERN SURGICAL SPECIALISTS PA
Entity Type:Organization
Organization Name:WESTERN SURGICAL SPECIALISTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMIEN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:JOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-204-4400
Mailing Address - Street 1:10115 W FOREST HILL BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3105
Mailing Address - Country:US
Mailing Address - Phone:561-204-4400
Mailing Address - Fax:561-204-4455
Practice Address - Street 1:10115 W FOREST HILL BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3105
Practice Address - Country:US
Practice Address - Phone:561-204-4400
Practice Address - Fax:561-204-4455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-24
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty