Basic Information
| Provider Information | |||||||||
| NPI: | 1568700284 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PARADISE SURGICAL, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 12390 | ||||||||
| Address2: | |||||||||
| City: | ST THOMAS | ||||||||
| State: | VI | ||||||||
| PostalCode: | 008015390 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3407748881 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9149 ESTATE THOMAS STE 308 | ||||||||
| Address2: | |||||||||
| City: | ST THOMAS | ||||||||
| State: | VI | ||||||||
| PostalCode: | 008023132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3407748881 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2013 | ||||||||
| LastUpdateDate: | 01/31/2013 | ||||||||
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| AuthorizedOfficialLastName: | SHAPIRO | ||||||||
| AuthorizedOfficialFirstName: | ADAM | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3407748881 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.