Provider Demographics
NPI:1942395249
Name:CARDIOVASCULAR & THORACIC SURGEONS OF PALM BEACH
Entity Type:Organization
Organization Name:CARDIOVASCULAR & THORACIC SURGEONS OF PALM BEACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-499-7707
Mailing Address - Street 1:5210 LINTON BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484
Mailing Address - Country:US
Mailing Address - Phone:561-499-7707
Mailing Address - Fax:561-499-1190
Practice Address - Street 1:5210 LINTON BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484
Practice Address - Country:US
Practice Address - Phone:561-499-7707
Practice Address - Fax:561-499-1190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21871OtherBLUE CROSS BLUE SHIELD
FL21871OtherBLUE CROSS BLUE SHIELD