Healthcare Provider Details
I. General information
NPI: 1962434969
Provider Name (Legal Business Name): HEMATOLOGY ONCOLOGY ASSOCIATES OF THE PALM BEACHES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/07/2006
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3450 LANTANA RD SUTIE 100
LAKE WORTH FL
33462-1329
US
IV. Provider business mailing address
3450 LANTANA RD SUITE 100
LAKE WORTH FL
33462-1329
US
V. Phone/Fax
- Phone: 561-965-1864
- Fax: 561-967-5005
- Phone: 561-965-1864
- Fax: 561-967-5005
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SURENDRA
K.
SIRPAL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 561-965-1864