1275588204 NPI number — HEMORRHOID CENTER OF SOUTH FLORIDA

Table of content: (NPI 1275588204)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275588204 NPI number — HEMORRHOID CENTER OF SOUTH FLORIDA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEMORRHOID CENTER OF SOUTH FLORIDA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275588204
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1950 OLD GALLOWS RD
Provider Second Line Business Mailing Address:
SUITE 220
Provider Business Mailing Address City Name:
VIENNA
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22182-3990
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-556-6620
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16800 NW 2ND AVE
Provider Second Line Business Practice Location Address:
SUITE 606
Provider Business Practice Location Address City Name:
NORTH MIAMI BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33169-5549
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-492-2226
Provider Business Practice Location Address Fax Number:
305-493-3338
Provider Enumeration Date:
05/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ABRAMOWITZ
Authorized Official First Name:
KENNETH
Authorized Official Middle Name:
MARK
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
703-556-6620

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com