Healthcare Provider Details

I. General information

NPI: 1508229410
Provider Name (Legal Business Name): US SURGICAL OF DELRAY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 03/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 LINTON BLVD SUITE E301
DELRAY BEACH FL
33445-6584
US

IV. Provider business mailing address

4800 LINTON BLVD SUITE E301
DELRAY BEACH FL
33445-6584
US

V. Phone/Fax

Practice location:
  • Phone: 561-921-0380
  • Fax: 561-272-2421
Mailing address:
  • Phone: 561-921-0380
  • Fax: 561-272-2421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. KEITH GREENBERG
Title or Position: CEO
Credential:
Phone: 845-217-2480