Healthcare Provider Details

I. General information

NPI: 1831384569
Provider Name (Legal Business Name): ASHBERG SPECIALTY ORTHOPAEDICS,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 08/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2254 HIGHWAY A1A
INDIAN HARBOUR BEACH FL
32937-4922
US

IV. Provider business mailing address

2254 HIGHWAY A1A
INDIAN HARBOUR BEACH FL
32937-4922
US

V. Phone/Fax

Practice location:
  • Phone: 321-777-2273
  • Fax:
Mailing address:
  • Phone: 321-777-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LYALL JULIAN ASHBERG
Title or Position: PRESIDENT
Credential: MD
Phone: 321-777-2273