Healthcare Provider Details
I. General information
NPI: 1194775759
Provider Name (Legal Business Name): PALM BEACH NEUROSURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/12/2006
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4560 LANTANA RD STE 120
LAKE WORTH FL
33463-6998
US
IV. Provider business mailing address
4560 LANTANA RD STE 120
LAKE WORTH FL
33463-6998
US
V. Phone/Fax
- Phone: 561-433-4444
- Fax: 561-433-8877
- Phone: 561-433-4444
- Fax: 561-433-8877
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207T00000X |
| Taxonomy | Neurological Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STEVEN
A
DUTCHER
Title or Position: MANAGING PARTNER
Credential: DO
Phone: 561-433-4444