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General NPI Number Information
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NPI Number | 1841298437
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Entity Type | Organization
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Legal Business Name | WEST PALM OUTPATIENT SURGERY AND LASER CENTER LTD
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 200 NORTHPOINT PKWY
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-1967
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Country | US
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Telephone | 561-615-0110
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Fax | 561-615-8009
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Provider Business Mailing Address
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Address Line | 200 NORTHPOINT PKWY
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-1967
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Country | US
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Telephone | 561-615-0110
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Fax | 561-615-8009
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. BILLIE A. PAYNE
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Credential |
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Telephone | 615-665-1283
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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 | 1035
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License Number State | FL
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