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General NPI Number Information
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NPI Number | 1578676870
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Entity Type | Organization
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Legal Business Name | PLASTIC SURGERY INSTITUTE OF THE PALM BEACHES INC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 4601 MILITARY TRL SUITE 208
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City | JUPITER
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State | FL
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Zip | 33458-4834
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Country | US
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Telephone | 561-795-3787
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Fax | 561-798-0003
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Provider Business Mailing Address
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Address Line | 4601 MILITARY TRAIL SUITE 208
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City | JUPITER
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State | FL
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Zip | 33458
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Country | US
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Telephone | 561-795-3787
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Fax | 561-798-0003
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. HAROLD BAFITIS
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Credential | D.O.
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Telephone | 561-795-3787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OS0005647
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License Number State | FL
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