Healthcare Provider Details

I. General information

NPI: 1518535160
Provider Name (Legal Business Name): FLAGLER EYE SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2021
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 PALM BEACH LAKES BLVD STE 301
WEST PALM BEACH FL
33409-6504
US

IV. Provider business mailing address

2000 PALM BEACH LAKES BLVD STE 301
WEST PALM BEACH FL
33409-6504
US

V. Phone/Fax

Practice location:
  • Phone: 561-500-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HUGH GLATTS
Title or Position: ADMINISTRATOR
Credential:
Phone: 561-500-2020