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General NPI Number Information
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NPI Number | 1881357101
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Entity Type | Organization
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Legal Business Name | SURGICAL PEACE LLC
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Dates
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Enumeration Date | 10/14/2021
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Last Update Date | 10/14/2021
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Provider Practice Location Address
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Address Line | 4725 N FEDERAL HWY
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-4603
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Country | US
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Telephone | 954-771-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 420 3RD AVE S APT 2
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City | LAKE WORTH
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State | FL
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Zip | 33460-4204
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CSFA
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Name | JANHOI T CHAMBERS
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Credential | CSFA
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Telephone | 561-386-7295
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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