Organization
PALM BEACH SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISHNA TRIPURANENI MD (OWNER)
(561) 795-3330
Entity
Organization
Contact information
Practice address
1157 S STATE ROAD 7, WELLINGTON, FL 33414-6101
(561) 795-3330
(561) 795-1030
Mailing address
1157 S STATE ROAD 7, WELLINGTON, FL 33414-6101
(561) 795-3330
(561) 795-1030
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1185
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075618100
—
FL
01
—
6E5
BCBS
FL
01
—
F1412
MEDICARE PTAN
FL
Enumeration date
08/30/2006
Last updated
10/08/2010
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