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General NPI Number Information
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NPI Number | 1982676227
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Entity Type | Organization
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Legal Business Name | THE PALMETTO ASC, LLC
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 2140 W 68TH ST SUITE 102
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City | HIALEAH
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State | FL
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Zip | 33016-1815
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Country | US
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Telephone | 305-512-8220
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Fax | 305-512-4945
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Provider Business Mailing Address
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Address Line | 2140 W 68TH ST SUITE 102
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City | HIALEAH
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State | FL
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Zip | 33016-1815
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Country | US
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Telephone | 305-512-8220
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Fax | 305-512-4945
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | TIFFANY JANE JARAMILLO
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Credential |
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Telephone | 305-512-8220
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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 | 1055
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License Number State | FL
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