Provider Demographics
NPI:1770929044
Name:SURGCENTER OF PALM BEACH GARDENS
Entity type:Organization
Organization Name:SURGCENTER OF PALM BEACH GARDENS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:COLLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMAISTRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-781-2921
Mailing Address - Street 1:900 VILLAGE SQUARE CROSSING STE 100
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4547
Mailing Address - Country:US
Mailing Address - Phone:561-429-6880
Mailing Address - Fax:561-429-6881
Practice Address - Street 1:900 VILLAGE SQUARE CROSSING
Practice Address - Street 2:SUITE 100
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4543
Practice Address - Country:US
Practice Address - Phone:561-429-6880
Practice Address - Fax:561-429-6881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical