MEDICARE: HSS PALM BEACH AMBULATORY SURGERY CENTER, LLC

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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1790241073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HSS PALM BEACH AMBULATORY SURGERY CENTER, LLC

Provider Business Mailing Address
First Line	:	300 PALM BEACH LAKES BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-2711
Country	:	US
Telephone Number	:	561-725-4300
Fax Number	:	561-725-4310

Provider Business Practice Location Address
First Line	:	300 PALM BEACH LAKES BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-2711
Country	:	US
Telephone Number	:	561-725-4300
Fax Number	:	561-725-4310

Authorized Official
Title or Position	:	OFFICER / AUTHORIZED OFFICER
Name	:	COLLIN LEMAISTRE
Credential	:
Telephone Number	:	469-250-3640

Provider Enumeration Date	:	02/12/2019
Last Update Date	:	09/13/2024

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