MEDICARE: PSHS ALPHA PARTNERS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	1069	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	170233100	OTHER	FL	US DEPT OF LABOR
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	67G	OTHER	FL	BLUE CROSS BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033106612
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSHS ALPHA PARTNERS LLC

Provider Business Mailing Address
First Line	:	7408 LAKE WORTH RD STE 900
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-2502
Country	:	US
Telephone Number	:	561-433-5700
Fax Number	:	561-433-5901

Provider Business Practice Location Address
First Line	:	7408 LAKE WORTH RD STE 900
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-2502
Country	:	US
Telephone Number	:	561-433-5700
Fax Number	:	561-433-5901

Authorized Official
Title or Position	:	OFFICER AND AUTHORIZED OFFICIAL
Name	:	JENNIFER B. BALDOCK
Credential	:
Telephone Number	:	615-234-5954

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	05/09/2024

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Directions to “PSHS ALPHA PARTNERS LLC ” Practice Location

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