Provider Demographics
NPI:1831384569
Name:ASHBERG SPECIALTY ORTHOPAEDICS,LLC
Entity type:Organization
Organization Name:ASHBERG SPECIALTY ORTHOPAEDICS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LYALL
Authorized Official - Middle Name:JULIAN
Authorized Official - Last Name:ASHBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-777-2273
Mailing Address - Street 1:2254 HIGHWAY A1A
Mailing Address - Street 2:
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-4922
Mailing Address - Country:US
Mailing Address - Phone:321-777-2273
Mailing Address - Fax:
Practice Address - Street 1:2254 HIGHWAY A1A
Practice Address - Street 2:
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4922
Practice Address - Country:US
Practice Address - Phone:321-777-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty