NPIMap

Organization Active NPI

South Palm Ambulatory Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Boca Raton, FL
National Provider Identifier
1285642652
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SOUTH PALM AMBULATORY SURGERY CENTER, LLC
Practice address
1905 Clint Moore Rd
Suite 115
Boca Raton, FL 33496-2658
Phone
(561) 807-8090
Fax
(561) 807-8100
NPI assigned
Aug 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Gregory R Cohen, MD
Title
President
Phone
(561) 981-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X FL Primary

Addresses

Primary practice location

1905 Clint Moore Rd
Suite 115
Boca Raton, FL 33496-2658

Mailing address

1905 Clint Moore Rd
Suite 115
Boca Raton, FL 33496-2658
Phone (561) 807-8090

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1285642652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 CLINT MOORE RD",
            "address_2": "SUITE 115",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334962658",
            "telephone_number": "561-807-8090",
            "fax_number": "561-807-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 CLINT MOORE RD",
            "address_2": "SUITE 115",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334962658",
            "telephone_number": "561-807-8090",
            "fax_number": "561-807-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PALM AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-981-8400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.