1699153718 NPI number — OUTPATIENT SERVICES FLORIDA, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699153718 NPI number — OUTPATIENT SERVICES FLORIDA, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OUTPATIENT SERVICES FLORIDA, INC
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:
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:
1699153718
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/08/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3400 34TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT LAUDERDALE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33308
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-200-8303
Provider Business Mailing Address Fax Number:
954-200-8320

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6600 COW PEN RD
Provider Second Line Business Practice Location Address:
SUITE 250
Provider Business Practice Location Address City Name:
MIAMI LAKES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33014-7600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-200-8308
Provider Business Practice Location Address Fax Number:
954-200-8320
Provider Enumeration Date:
05/08/2015

Additional Information

Authorized Official

Authorized Official Last Name:
BHATT
Authorized Official First Name:
ASHISH
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
954-200-8308

Provider Taxonomy Codes

  • Taxonomy code: 261QR0405X , with the licence number:  APPLIED FOR , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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