Organization
SOUTH PALM ORTHOSPINE INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEWART G EIDELSON M.D. (OWNER)
(561) 742-5959
Entity
Organization
Contact information
Practice address
8198 JOG RD, SUITE 100, BOYNTON BEACH, FL 33472-2998
(561) 742-5959
(561) 734-2226
Mailing address
8198 JOG RD, #100, BOYNTON BEACH, FL 33472-2998
(561) 742-5959
(561) 734-2226
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
ME55593
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730375346
NPI
FL
Enumeration date
09/18/2007
Last updated
11/13/2009
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