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General NPI Number Information
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NPI Number | 1245988955
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Entity Type | Organization
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Legal Business Name | PALM BEACH REGIONAL OPCO LLC
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Dates
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Enumeration Date | 03/11/2022
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Last Update Date | 03/11/2022
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Provider Practice Location Address
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Address Line | 11030 RCA CENTER DR STE 3001
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4276
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Country | US
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Telephone | 212-220-9222
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Fax |
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Provider Business Mailing Address
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Address Line | 505 PARK AVE STE 1700
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City | NEW YORK
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State | NY
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Zip | 10022-1106
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Country | US
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Telephone | 212-220-9922
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | FELIKS KOGAN
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Credential |
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Telephone | 917-288-4414
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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 |
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License Number State |
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