Healthcare Provider Details
I. General information
NPI: 1285037176
Provider Name (Legal Business Name): HAND & WRIST SPECIALISTS OF THE PALM BEACHES PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/06/2014
Last Update Date: 11/29/2021
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2237 S CONGRESS AVE
PALM SPRINGS FL
33406-7605
US
IV. Provider business mailing address
2237 S CONGRESS AVE
PALM SPRINGS FL
33406-7605
US
V. Phone/Fax
- Phone: 561-508-7066
- Fax:
- Phone: 561-508-7066
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0106X |
| Taxonomy | Orthopaedic Hand Surgery Physician |
| License Number | ME102418 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
LAURA
WHITE
KOLSHAK
Title or Position: OWNER
Credential: M.D., M.S.
Phone: 561-508-7066