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General NPI Number Information
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NPI Number | 1033106612
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Entity Type | Organization
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Legal Business Name | PSHS ALPHA PARTNERS LLC
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 05/09/2024
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Provider Practice Location Address
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Address Line | 7408 LAKE WORTH RD STE 900
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City | LAKE WORTH
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State | FL
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Zip | 33467-2502
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Country | US
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Telephone | 561-433-5700
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Fax | 561-433-5901
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Provider Business Mailing Address
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Address Line | 7408 LAKE WORTH RD STE 900
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City | LAKE WORTH
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State | FL
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Zip | 33467-2502
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Country | US
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Telephone | 561-433-5700
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Fax | 561-433-5901
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Authorized Official
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Title or Position | OFFICER AND AUTHORIZED OFFICIAL
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Name | JENNIFER B. BALDOCK
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Credential |
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Telephone | 615-234-5954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 1069
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License Number State | FL
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