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General NPI Number Information
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NPI Number | 1649456815
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Entity Type | Organization
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Legal Business Name | GARDENS SURGERY CENTER, LLC
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 01/17/2008
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Provider Practice Location Address
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Address Line | 2865 PGA BLVD
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-2910
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Country | US
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Telephone | 561-776-9555
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Fax | 561-776-8495
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Provider Business Mailing Address
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Address Line | 2865 PGA BLVD
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-2910
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Country | US
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Telephone | 561-776-9555
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Fax | 561-776-8495
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DR. GREGORY SCOTT DELANGE
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Credential | M.D.
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Telephone | 561-776-9555
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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 | 360
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License Number State | FL
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