Provider Demographics
NPI:1699355651
Name:BEYOND THE SCOPE ORTHOPAEDICS AND SPORTS MEDICINE
Entity type:Organization
Organization Name:BEYOND THE SCOPE ORTHOPAEDICS AND SPORTS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPAEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:PALSIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-361-5550
Mailing Address - Street 1:200 E HIBISCUS BLVD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3156
Mailing Address - Country:US
Mailing Address - Phone:321-361-5550
Mailing Address - Fax:321-728-7553
Practice Address - Street 1:200 E HIBISCUS BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3156
Practice Address - Country:US
Practice Address - Phone:321-361-5550
Practice Address - Fax:321-728-7553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-13
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty