Organization Active NPI

Specialized Aesthetics, P.a.

  • Plastic Surgery Physician
  • Palm Beach Gardens, FL
National Provider Identifier
1295968469
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
SPECIALIZED AESTHETICS, P.A.
Practice address
2401 Pga Blvd
Suite 150
Palm Beach Gardens, FL 33410-3590
Phone
(561) 624-7777
Fax
(561) 624-9995
NPI assigned
Sep 3, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Authorized official

Name
Jennifer Lucky
Title
Business Administrator
Phone
(561) 624-7777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

2401 Pga Blvd
Suite 150
Palm Beach Gardens, FL 33410-3590

Mailing address

2401 Pga Blvd
Suite 150
Palm Beach Gardens, FL 33410-3590
Phone (561) 624-7777

Other names 1

  • Hass Plastic Surgery Doing business as

National Provider Directory

National Provider Directory

Locations

2401 Pga Blvd
Ste 150
Palm Beach Gardens, FL 33410
Phone (561) 624-7777

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1295968469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 PGA BLVD",
            "address_2": "SUITE 150",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103590",
            "telephone_number": "561-624-7777",
            "fax_number": "561-624-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 PGA BLVD",
            "address_2": "SUITE 150",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103590",
            "telephone_number": "561-624-7777",
            "fax_number": "561-624-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED AESTHETICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-03",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "LUCKY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "561-624-7777"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hass Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.