MEDICARE: GARDENS PLASTIC SURGERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00368	OTHER	FL	BLUECROSS BLUESHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235248162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARDENS PLASTIC SURGERY

Provider Business Mailing Address
First Line	:	11020 RCA CENTER DR
Second Line	:	SUITE 2010
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4277
Country	:	US
Telephone Number	:	561-881-8800
Fax Number	:	561-848-5878

Provider Business Practice Location Address
First Line	:	11020 RCA CENTER DR
Second Line	:	SUITE 2010
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4277
Country	:	US
Telephone Number	:	561-881-8800
Fax Number	:	561-848-5878

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. MARK ALAN PINSKY
Credential	:	MD
Telephone Number	:	561-881-8800

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	01/07/2011

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1922051770 — MRS. LORI BETH OSWALD PA-C
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Practice Location Address:

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33410-4277

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Practice Location Address:

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1376675140 — CORNEA & REFRACTIVE CONSULTANTS OF THE PALM BEACHES, PA
Practice Location Address:

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1528230653 — EVAN R SHAPIRO MD
Practice Location Address:

11020 RCA CENTER DR , SUITE 2014
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Directions to “GARDENS PLASTIC SURGERY ” Practice Location

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