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NPI Code Detail

MEDICARE: BOYNTON BEACH ASC, LLC

MEDICARE: BOYNTON BEACH ASC, 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
1261QA1903XAmbulatory Surgical Clinic/Center903FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861550246
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOYNTON BEACH ASC, LLC
Provider Business Mailing Address
First Line : 1717 W WOOLBRIGHT RD
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33426-6319
Country : US
Telephone Number : 561-737-8031
Fax Number : 561-736-5062
Provider Business Practice Location Address
First Line : 1717 W WOOLBRIGHT RD
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33426-6319
Country : US
Telephone Number : 561-737-8031
Fax Number : 561-736-5062
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. LEE S FRIEDMAN
Credential : M.D.
Telephone Number : 561-737-5500
Provider Enumeration Date : 12/05/2006
Last Update Date : 08/22/2020

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1336201359 — DR. LEE SCOTT FRIEDMAN M.D.
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Practice Fax: 561-737-7055

Directions to “BOYNTON BEACH ASC, LLC ” Practice Location

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