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NPI Code Detail

MEDICARE: RAND SURGICAL PAVILLION CORP

MEDICARE: RAND SURGICAL PAVILLION CORP
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
1261QA1903XAmbulatory Surgical Clinic/Center794FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578515995
Entity Type Code : Organization
Provider Name (Legal Business Name) : RAND SURGICAL PAVILLION CORP
Provider Business Mailing Address
First Line : 5 W SAMPLE RD
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33064-3542
Country : US
Telephone Number : 954-782-1700
Fax Number : 954-782-3432
Provider Business Practice Location Address
First Line : 5 W SAMPLE RD
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33064-3542
Country : US
Telephone Number : 954-782-1700
Fax Number : 954-782-3432
Authorized Official
Title or Position : ADMINISTRATOR
Name : DEBORAH G RAND
Credential :
Telephone Number : 954-782-1700
Provider Enumeration Date : 05/16/2006
Last Update Date : 06/15/2021

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