Provider Demographics
NPI:1982691614
Name:COMMUNITY SURGICAL SPECIALISTS P.A.
Entity Type:Organization
Organization Name:COMMUNITY SURGICAL SPECIALISTS P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELNICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-575-7875
Mailing Address - Street 1:210 JUPITER LAKES BLVD
Mailing Address - Street 2:3105
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7191
Mailing Address - Country:US
Mailing Address - Phone:561-575-7875
Mailing Address - Fax:561-575-5874
Practice Address - Street 1:210 JUPITER LAKES BLVD
Practice Address - Street 2:3105
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7191
Practice Address - Country:US
Practice Address - Phone:561-575-7875
Practice Address - Fax:561-575-5874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0074966208600000X
FL57409208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Not Answered208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
40488Medicare ID - Type Unspecified