NPIMap

Organization Active NPI

Palm Beach General Surgery LLC

  • Surgery Physician
  • Miami, FL
National Provider Identifier
1992378145
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
PALM BEACH GENERAL SURGERY LLC
Practice address
11760 SW 40TH St Ste 722
Miami, FL 33175-8101
Phone
(305) 669-7331
NPI assigned
Jul 23, 2021
Organization subpart
Yes
Parent organization
PALM BEACH GENERAL SURGERY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Authorized official

Name
William Tedrick Johnson
Title
Vice President
Phone
(615) 372-3375

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

11760 SW 40TH St Ste 722
Miami, FL 33175-8101

Mailing address

2000 Health Park Dr
Brentwood, TN 37027-4692
Phone (615) 372-5426

National Provider Directory

National Provider Directory
Tax ID family
Palm Beach General Surgery LLC7 organizations share this tax ID, including this one
Part of
Palm Beach General Surgery LLC

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11760 SW 40th St
Ste 722
Miami, FL 33175
Phone (305) 559-1883

NPI Registry JSON

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1992378145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274692",
            "telephone_number": "615-372-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11760 SW 40TH ST STE 722",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331758101",
            "telephone_number": "305-669-7331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH GENERAL SURGERY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALM BEACH GENERAL SURGERY LLC",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TEDRICK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-372-3375"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.