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General NPI Number Information
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NPI Number | 1801015177
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Entity Type | Organization
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Legal Business Name | PALM BEACH GENERAL SURGERY LLC
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5511 S CONGRESS AVE SUITE 135
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City | ATLANTIS
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State | FL
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Zip | 33462-1140
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Country | US
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Telephone | 561-548-3716
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Fax |
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Provider Business Mailing Address
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Address Line | 5511 S CONGRESS AVE SUITE 135
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City | ATLANTIS
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State | FL
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Zip | 33462-1140
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Country | US
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Telephone | 561-548-3716
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Fax |
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Authorized Official
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Title or Position | VP
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Name | MR. GARY DUNCAN
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Credential |
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Telephone | 561-548-3821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME93782
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License Number State | FL
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