Basic Information
| Provider Information | |||||||||
| NPI: | 1467872242 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PALM BEACH ORTHOPAEDIC INSTITUTE, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4215 BURNS RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | PALM BEACH GARDENS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334104625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617271122 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7701 SOUTHERN BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334113803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616947776 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2014 | ||||||||
| LastUpdateDate: | 08/26/2022 | ||||||||
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| AuthorizedOfficialLastName: | CHANDRADAT | ||||||||
| AuthorizedOfficialFirstName: | PRIYA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5616947776 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | PALM BEACH ORTHOPAEDIC INSTITUTE, PA | ||||||||
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| NPICertificationDate: | 08/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332900000X | ME77605 | FL | Y | Suppliers | Non-Pharmacy Dispensing Site |
No ID Information.