Organization
SOUTH PALM BEACH SURGICAL ASSOCIATES, PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN WIDEROFF M.D. (OWNER)
(561) 939-0455
Entity
Organization
Contact information
Practice address
1601 CLINT MOORE RD, SUITE 145, BOCA RATON, FL 33487-2768
(561) 939-0455
(561) 939-5460
Mailing address
1601 CLINT MOORE RD, SUITE 145, BOCA RATON, FL 33487-2768
(561) 939-0455
(561) 939-5460
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME35997
FL
Other
Enumeration date
09/01/2011
Last updated
09/01/2011
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