Organization
SOUTH PALM ORTHOSPINE INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEWART G EIDELSON MD (OWNER)
(561) 742-5959
Entity
Organization
Contact information
Practice address
15300 JOG RD, SUITE 107-108, DELRAY BEACH, FL 33446-2164
(561) 742-5959
(561) 734-2226
Mailing address
15300 JOG RD, SUITE 107-108, DELRAY BEACH, FL 33446-2164
(561) 742-5959
(561) 734-2226
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME0055593
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00425
BCBS
FL
01
—
1598893885
NPI
FL
01
—
DQ8555
RR MEDICARE
FL
Enumeration date
03/01/2007
Last updated
09/09/2014
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