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General NPI Number Information
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NPI Number | 1306843867
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Entity Type | Organization
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Legal Business Name | PALM BEACH OUTPATIENT SURGICAL CENTER, LLC
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 2889 10TH AVE N STE 203
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City | PALM SPRINGS
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State | FL
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Zip | 33461-3045
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Country | US
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Telephone | 561-469-6208
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Fax | 561-725-8795
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Provider Business Mailing Address
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Address Line | 2889 10TH AVE N STE 306
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City | PALM SPRINGS
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State | FL
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Zip | 33461-3045
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Country | US
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Telephone | 561-964-0707
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Fax | 561-467-4175
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Authorized Official
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Title or Position | PRESIDENT
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Name | MADONNA W COFFMAN
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Credential |
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Telephone | 561-576-8436
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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 | 854
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License Number State | FL
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number |
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License Number State |
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