MEDICARE: CENTER FOR PLASTIC SURGERY, INC.

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	2086S0122X	Plastic and Reconstructive Surgery Physician	ME22502	FL

General Provider Information

NPI Number	:	1104946730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR PLASTIC SURGERY, INC.

Provider Business Mailing Address
First Line	:	1501 FOREST HILL BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6000
Country	:	US
Telephone Number	:	561-655-0001
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 FOREST HILL BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6000
Country	:	US
Telephone Number	:	561-655-0001
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KRIS M. REDDY
Credential	:	M.D.
Telephone Number	:	561-655-0001

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	01/10/2012

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