South Palm Beach Surgical Associates, PL

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME35997 Issued in FL

Legal business name

SOUTH PALM BEACH SURGICAL ASSOCIATES, PL

Practice address

1601 Clint Moore Rd
Suite 145
Boca Raton, FL 33487-2768

Phone

(561) 939-0455

Fax

(561) 939-5460

NPI assigned

Sep 1, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan Wideroff, M.D.

Title

Owner

Phone

(561) 939-0455

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314835200000",
    "number": "1750662912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CLINT MOORE RD",
            "address_2": "SUITE 145",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334872768",
            "telephone_number": "561-939-0455",
            "fax_number": "561-939-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 CLINT MOORE RD",
            "address_2": "SUITE 145",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334872768",
            "telephone_number": "561-939-0455",
            "fax_number": "561-939-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PALM BEACH SURGICAL ASSOCIATES, PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-01",
        "last_updated": "2011-09-01",
        "status": "A",
        "authorized_official_last_name": "WIDEROFF",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-939-0455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME35997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Florida Therapy for Families PLLC
• South Florida TMS LLC.
• South Palm Ambulatory Surgery Center, LLC
• South Palm Beach Health Group PLLC
• South Palm Beach Medical Associates, PA
• South Palm Orthospine Institute
• South Palm Physical Therapy Services Inc
• South Palm Plastic Surgery Associates, P.L.
• South Palm Primary Care LLC
• South Pearl Dental, Inc

• Surgery Physician in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; 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.