# OBGYN SPECIALISTS OF LAKESIDE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** OBGYN SPECIALISTS OF THE PALM BEACHES PA
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1134467129
- **Legal business name:** OBGYN SPECIALISTS OF THE PALM BEACHES PA
- **Authorized official:** JOHN BURIGO MD (MANAGER)
- **Authorized official phone:** (561) 275-7509

## Contact information

- **Practice address:** 39200 HOOKER HWY, BELLE GLADE, FL 33430-5368
- **Practice address phone:** (561) 996-6571
- **Practice address fax:** (561) 992-9722
- **Mailing address:** 2979 PGA BLVD, SUITE 200, PALM BEACH GARDENS, FL 33410-2911
- **Mailing address phone:** (561) 275-7604
- **Mailing address fax:** (561) 802-5385

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | ME35335 | FL | Yes |
| 207VM0101X | Maternal & Fetal Medicine Physician | ME35335 | FL | — |

## Other

- **Enumeration date:** 01/25/2013
- **Last updated:** 07/06/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 008257000 | — | FL |