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Organization

PALM BEACH GENERAL SURGERY LLC

Active
Parent organization
PALM BEACH GENERAL SURGERY LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
PALM BEACH GENERAL SURGERY LLC
Authorized official
WILLIAM TEDRICK JOHNSON (VICE PRESIDENT)
(615) 372-3375
Entity
Organization

Contact information

Practice address
11760 SW 40TH ST STE 722, MIAMI, FL 33175-8101
(305) 669-7331
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
(615) 372-5426

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Enumeration date
07/23/2021
Last updated
07/23/2021
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